Lab Week Form Packet

Guidelines

Northwood University’s Code of Ethics is FRESH AIR – Freedom, Respect, Empathy, Spirituality, Honesty, Achievement, Integrity, and Responsibility. During camp, students are expected to follow the University’s Code of Ethics, which you can find on the next page.

Throughout the week, camp staff is in charge of the students’ safety and well-being. In order to provide a fun and safe camp experience, we ask that all students and parents read and sign the following guidelines, acknowledging that you agree to follow them. Failure to abide by the guidelines can result in you being asked to leave camp without a refund. The parent/guardian will be responsible for coming to pick up the student.

I agree to follow the rules and guidelines that have been set forth in this document.
I agree to follow the instructions of camp staff/faculty.
I agree to respect my fellow campers and their parent/guardians, in addition to camp staff/faculty.
I agree that I am responsible for any damage to housing or Northwood University’s facilities. If I lose my room key, I acknowledge that there is a $150 fee to replace the key and door lock that I will be responsible for.
In the case of an emergency, I agree to follow Northwood University’s emergency guidelines. Evacuation routes are posted in classrooms, with shelter locations marked.

By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.

Student Signature(Required)

Date(Required)

Parent Signature(Required)

Date(Required)

Code of Ethics

The community of students, faculty, and staff of Northwood University affirms this code of ethics as the behaviors that advance our shared values:

Freedom – Exercise personal freedom and accountability that uplifts and respects individual freedom for all.

Respect – Treat all others with consideration for their circumstances and with thoughtful regard for their value as human beings.

Empathy – Show compassion for the feelings, throughs, and conditions of others.

Spirituality – Seek the spiritual development necessary to create our happiness, inspiration, reverence, meaning, and purpose.

Honesty – Embrace truthfulness, fairness, probity, and demand the absence of fraud or deceit in ourselves and others with whom we act.

Achievement – Demonstrate persistence, determination, and effort in order to achieve our goals and applaud the high achievements of others.

Integrity – Be guided by a code of behavior which reflects our values, unimpeded by circumstance, personal gain, public pressure, or private temptation.

Responsibility – Be accountable for the care and welfare of others and responsible for the intended and unintended consequences of our actions.

By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.

Student Signature(Required)

Date(Required)

Parent Signature(Required)

Date(Required)

Media Release

Organization/Program: Lab Camp

Dates: June 15, 2025 – June 20, 2025

Location: 4000 Whiting Drive, Midland, MI 48640

I authorize LAB Camp to record and edit my likeness, image, voice, interview, and performance. I agree that LAB Camp may use and authorize the use of any part of this documentation for, but not limited to, exhibition, publication, educational, and website purpose. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording. I also understand that this material may be used in diverse settings with an unrestricted geographic area.

By signing this form, I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release all claims against Northwood University and LAB Camp utilizing this material for the above purposes.

Name(Required)

First Last

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.

Student Signature(Required)

Date(Required)

Parent Signature(Required)

Date(Required)

Emergency Contacts

Name of Student(Required)

First Last

Personal Contact Information

Home Address(Required)

Street Address Address Line 2 City State ZIP Code

Student Cellphone Number(Required)

Primary Emergency Contact

Emergency Contact Name(Required)

First Last

Relationship(Required)

Home Address(Required)

Street Address Address Line 2 City State ZIP Code

Cellphone Number(Required)

Home Phone Number(Required)

Work Phone Number(Required)

Employer(Required)

Secondary Emergency Contact

Emergency Contact Name(Required)

First Last

Relationship(Required)

Home Address(Required)

Street Address Address Line 2 City State ZIP Code

Cellphone Number(Required)

Home Phone Number(Required)

Work Phone Number(Required)

Employer(Required)

Medical Contact Information

Doctor Name(Required)

First Last

Phone(Required)

Doctor Name(Required)

First Last

Phone(Required)

By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.

Student Signature(Required)

Date(Required)

Parent Signature(Required)

Date(Required)

Medical Consent & Liability

While enrolled in a summer sports camp at Northwood University (“Northwood”), my son/daughter may participate in sports or other events or contests of an athletic nature (“Athletic Events”) sponsored entirely or in part by Northwood. I understand that the participation of my son/daughter in Athletic Events involved risk of injury to him/her and his/her property and that no amount of precaution by Northwood can eliminate such risk. Because of this and in consideration of Northwood’s willingness to sponsor Athletic Events and to allow my son/daughter to participate in Athletic Event, I agree as follows:

My son/daughter will participate in Athletic Events in a careful and prudent manner and will attempt whenever possible to minimize the risk of injury to himself/herself.
I hereby release Northwood, its agents, officers, employees, and trustees from liability for any injury to my son/daughter or his/her property suffered at, or arising out of participation in an Athletic Event, including any such injury to his/her person or property caused in whole or in part by the negligence of Northwood, its agents, officers, employees, or trustees. I give this waiver and release intending to legally bind myself and my heirs, representatives, successors, and assigns.
I hereby authorize the camp director or his/her designee to act in the best interest of my son/daughter in seeking medical attention in the event of an accident.
I know of no medical condition or injury that would preclude my son/daughter from participating safely in Athletic Events.

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Medical Consent & Liability

I have carefully read this release and waiver of liability/consent for medical care. I understand its terms and have signed voluntarily.

Name of Camper(Required)

First Last

Health Insurance(Required)

ID/Policy/Group #(Required)

Camper's Date of Birth(Required)

Subscriber Name(Required)

First Last

Subscriber's Date of Birth(Required)

Emergency Contact #1(Required)

First Last

Emergency Contact Phone Number(Required)

Emergency Contact #2(Required)

First Last

Emergency Contact Phone Number(Required)

Allergies/Medications/Other Medical Considerations(Required)

By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.

Student Signature(Required)

Date(Required)

Parent Signature(Required)

Date(Required)

Medication Prescription & Dietary Restrictions

Please list medications or natural remedies that your attendee will be taking during LAB Camp. If your attendee does not have any medications or natural remedies than you can skip this step and move onto the next step. The following guidelines must be met while onsite:

All prescription medications MUST be in the original pharmacy labeled container and have your attendee’s name on the bottle.
All over the counter or natural remedies must be in the original manufacturer’s container.

Student Name

First Last

Emergency Contact Name

First Last

Emergency Contact Phone Number

Medications

Name of Medication

Strength/Frequency

Condition

Physician

Notes

Click the plus button to add each medication.

Allergies

Pharmacy/Prescription Drug Plan

Dietary Restriction(s)

Vegetarian

Vegan

Kosher

Gluten Free

Halal

Food Allergy

Other

Please describe "Other"

Please describe "Food Allergy"

Comments

Field-Trip & Off-Campus Activity

Camp/Class/Club: Lab Week

Description of Event: Multiple Educational Off-Campus Opportunities

Instructor/Advisor: Patrick McElgunn

Means of Transportation: Bus

Waiver of Liability for Field Trips or Off-Campus Activities

I acknowledge and agree that there are certain risks inherent in my participation in field trips or off-campus activities. I voluntarily assume all risk of injury of myself or damage to my property and agree to hold harmless Northwood University, its directors, officers, employees, and authorized agents from all liability, claims, or causes of action arising out of my transportation to and from or my participation in this field trip or off-campus activity. If I choose to transport other persons or students in my personal vehicle to this activity, I certify that I have adequate insurance and I agree that I shall indemnify Northwood University against any claim brought against them by my passengers.

Expectation of Student Conduct at Northwood Events

I will follow the Northwood University Student Code of Conduct as outlined in the Student Handbook. In addition, I will not posses or use alcohol or unlawful substances while participating in this University sponsored activity.

I understand that students at Northwood University are members of the university community. All members of the University community have the obligation to adhere to the policies and regulations of the University and the laws of the state and local jurisdictions. The University holds students accountable to a higher standard of behavior than what is minimally expected by public law.

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Field-Trip & Off-Campus Activity

The University’s policy is to hold students responsible for behavior at this public event. The behavior of students, both positive and negative, reflects upon the University. Students whose behavior is contrary to public law and/or university regulations and policies will be subject to disciplinary sanctions.

I understand the following ramifications of not abiding by the conduct outlined above may include, but are not limited to the following:

disciplinary probation;
restitution or reimbursement for damage to or misappropriation of institutional property;
suspension of rights and privileges, including participation in future extracurricular activities;
assignment of a failing grade for an examination, assignment, or course relating to this activity;
suspension from the camp for a specific period of time;
expulsion from the camp; or other penalties deemed appropriate under the circumstances.

I have carefully read this agreement and fully understand its contents. I am aware that signing this agreement constitutes a release of liability, as well as an additional agreement regulating by behavior. I sign it of my own free will.

By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.

Student Signature(Required)

Date(Required)

Parent Signature(Required)

Date(Required)

General Release of Liability

While enrolled at Northwood University summer camp, I understand that I may engage in or be exposed to activities and situations that pose a risk of injury to myself and my property, including, without limitation, campus activities, variety sports, activities, other events or contests of an athletic nature, field trips, and other on and off-campus learning experiences. I understand that my participation in the above-mentioned activities may involve risk of injury to myself and my property, and that no amount of precaution by Northwood can eliminate such risk. Because of this and in consideration of Northwood’s willingness to allow me to participate in such activities, I agree as follows:

I will participate in athletic events in a careful and prudent manner and will attempt whenever possible to minimize the risk of injury to myself and others. Athletic events include, but are not limited to, varsity sports, club sports, intramural sports, and other events or contests of an athletic nature.
I agree to exercise a reasonable degree of care to protect the safety of myself and others while participating in campus activities including, but not limited to, field trips and other on and off-campus learning experiences.
I hereby release Northwood, its agents, officers, employees, and trustees from liability for any injury to myself or my property suffered or arising out of an athletic or other event, including such injury to my person or property resulting from any cause other than the gross negligence of intentional misconduct of Northwood, its agents, officers, employees, or trustees. I give this waiver and release intending to legally bind myself and my heirs, representatives, successors, and assigns.

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LAB Week Packet

Guidelines

Code of Ethics

Media Release

Emergency Contacts

Personal Contact Information

Primary Emergency Contact

Secondary Emergency Contact

Medical Contact Information

Medical Consent & Liability

Medical Consent & Liability

Medication Prescription & Dietary Restrictions

Field-Trip & Off-Campus Activity

Field-Trip & Off-Campus Activity

General Release of Liability

General Release of Liability