REGISTRATION Register Early! Space is Limited REMEMBER THE DEADLINES!!! NEW Online Registration on our website: www.nmsd.k12.nm.us click on Statewide Services -class workshops & training - Family Education OR Registration and waiver forms are also available on our website: www.nmsd.k12.nm.us Please complete all sections of the forms E-Mail forms to: CECTevents@nmsd.k12.nm.us FAX forms to : 505-476-6371 Mail forms to: NMSD/CECT 1060 Cerrillos Rd. SF, NM 87505 Call 505-476-6400 for questions * If payment is applicable, we must have check or money order in our office by the deadline of March 15, 2019. Registration Checklist Registration Form Child/Youth Program Release Form (if applicable) Adult Release Form REMEMBER THE DEADLINES!! SCHEDULE Tentative schedule for the weekend Friday, March 29 th 4:30 6:30PM Check-in (Dinner on your own) Saturday, March 30 th 8AM Breakfast & Check-in 9AM 5PM 5PM 6:30PM Workshops & Panels (lunch provided) Dinner provided Sunday, March 31 st 8:30AM 9:30AM Breakfast provided 9:30AM 12PM Family Activities (to-go lunch provided) FAMILY TO FAMILY WEEKEND MARCH 29-31, 2019 REGISTER EARLY TO AVOID PAYING A FEE! No registrations accepted after March 15 New Mexico School for the Deaf Center for Educational Training & Consultation
CHILDREN S PROGRAM For all children 18 months to 11 years old. Infants under 18 months will stay with their parents/guardian. Deaf and hearing staff will provide programming leadership. Bring your own diapers for your children who are not potty-trained. Bring sunscreen and apply to your children in the morning before dropping them off at the Children s Program. Children should wear comfortable clothing that can get wet or dirty. Children will be participating in outdoor games, fun language activities, and more! THE EVENT Family to Family Weekend gives parents, siblings and extended family the opportunity to enjoy learning from energetic instructors in a comfortable environment. Join us for fun and learning! Lodging: Simple yet comfortable lodging is available in our on-campus cottages. Each room has 2 twin beds, 2 closets and a private bathroom Extra mattresses can be added to the rooms. (max of 2 extra mattresses per room) Simple towels and bedding are provided Community kitchen with refrigerator Heated and air conditioned cottages, (guests do not control temperature) Meals: Vegetarian and gluten free options will be available at all meals. Participants are encouraged to bring food, as needed, to accommodate additional dietary restrictions and/or preferences. Breakfast, lunch and dinner will be provided on Saturday Breakfast and a to-go sack lunch will be provided on Sunday. YOUTH PROGRAM For youth 12-18 years old Team building and group activities Wear comfortable clothes that you don t mind getting wet or dirty Bring sunscreen
Family to Family Weekend - Registration Form - March 29-31, 2019 FIRST COME, FIRST SERVED PLEASE COMPLETE ALL SECTIONS OF THE REGISTRATION FORM NO REGISTRATIONS ACCEPTED AFTER MARCH 15 th! March 11 March 15, 2019 Now March 10 For NM families of Deaf or hard of hearing children For NM families of Deaf or hard of hearing children $15.00 per adult (13 and up) NO CHARGE $8.00 per child (ages 3-12) Program fees will apply for all registrations received after March 10th Attendee/Family Contact: Address: City/State/Zip: (This attendee is also the designated family contact person) Email Address: Home Phone: Cell Phone: Age: Name of D/HH child in the family: Name Adults Attending Relation to D/HH Child Interpreter request (Spanish) Check all that apply Vegetarian? Lodging? Yes No Yes No Yes No Name Youth Program (12-18 yrs) Age Check all that apply primary language Additional Important Information (behavior support needs, allergies, t ) Check all that apply Check one Language Vegetarian? Lodging? Deaf HH Hearing English Spanish ASL Yes No Yes No Name Children s Program (under 12 yrs) Age Check all that apply primary language Additional Important Information (behavior support needs, allergies, t ) Check all that apply Check one Language Vegetarian? Lodging? Deaf HH Hearing English Spanish ASL Yes No Yes No Mail forms & Payment (if applicable) to: NMSD/CECT 1060 Cerrillos Road, Santa Fe, NM 87505 FAX forms to: 505.476-6371 E-Mail forms to: CECTevents@NMSD.K12.NM.US * If payment is applicable, we MUST have payment in our office by the deadline of March 15, 2019 Please contact us ASAP regarding cancellations OR if plans to attend Family to Family Weekend have changed. Voice Phone: 505-476-6400 or E-Mail : CECTevents@NMSD.K12.NM.US CECT_F2F_2019 Feb 5
Release Form Pertaining to ALL Adult Program Participants(18 years & older) All adult participants MUST check the Medical Release All adult participants MUST check the Release of all Claims The Photo/Video box is optional (only check if you agree) Medical Release I understand that I am responsible for the medical needs for myself, including medication and/or medical equipment needed during my stay. I understand that in the event of a minor emergency for myself, I will receive simple first aid treatment. I will be responsible thereafter for the care of myself. In the case of a more serious injury or illness, appropriate outside emergency personnel will be called. The emergency personnel will decide the best course of action. I understand that I am responsible for administering all medications or any other medical treatment for myself. Release of all Claims I hereby release NMSD/CECT Program, its agents and employees, from all actions, damages, causes of action, claims or demands which I may have against the NMSD/CECT Program, its agents and employees, for all personal injuries known or unknown which I may incur by participating in the NMSD/CECT Event. I, the undersigned have read this release and understand all its terms. I execute it voluntarily and with full knowledge of it significance. Photograph/Video Release (optional-check only if you agree) I understand that photographs and/or video may be taken during the course of the event. These images will be used for training, publicity and/or fundraising purposes for NMSD. My signature below indicates consent for myself to be photographed and/or videotaped. NAME (PLEASE PRINT CLEARLY) SIGNATURE DATE CECT_EventForm_2019 FEB5
Child/Youth Program: Provided for children 18 months to 17 years old. There is no cost for this program and only available for children/youth related to a deaf or hard of hearing child. Parent s/guardian s Name(Please Print): Cell Phone: Phone: E-Mail: * Please read and sign the Child/Youth Program Release Form on back of this page Child/Youth Program Ages 18 mo. to 17 years (list below) NOTE: There is not cost for the Child/Youth Program and is ONLY available for children/youth related to a deaf or hard of hearing child. First and Last Name (please print clearly) Communication Sign, Voice, Both, Other (select only one) Age Deaf / Hard of Hearing/ Deaf-blind /Hearing (select only one) Medical Information (list allergies or N/A if none) please print clearly Medication and Dosage (list meds or N/A if none) please print clearly Special Needs (specify or N/A if none) please print clearly Other Important Information (please print clearly) Child/Youth 1 Child/Youth 2 Child/Youth 3 Child/Youth 4 CECT_EventForm_Page 1 of 2_2019 Feb 5
RELEASE FORM PERTAINS TO CHILDREN ATTENDING CECT EVENT CHILD/YOUTH PROGRAM Parent or Guardian signing this form must have authorization to make decisions on behalf of children/ youth listed on page 1 of this Child/Youth Program Release Form. (If you are not the legal guardian, please contact our office to obtain the Guardian Release Form) which must be submitted with your registration. All information below pertains to all children/youth listed on page 1 of this Youth Program Release Form. Thank you. Medical Release I (Parent/Guardian) understand that I am responsible for the medical needs for my children including medication and/or medical equipment needed during our time at NMSD. I am also responsible for the administering all medications or any other medical treatment. I understand that in the event of a minor emergency my children will receive simple first aid treatment. I will be informed at the end of the day of what care my children received. I will be responsible thereafter for the care of my children. In the case of a more serious injury or illness, 911 will be called. I will immediately be informed of the emergency. The 911 responders will decide the best course of action. Release of all Claims I (Parent/Guardian) hereby release the Child/Youth Program, its agents and employees from all actions, damages, causes of action, claims or demands which my children, family members, spouse, heirs, executors, administrators or assigns may have against the Child/Youth Program, its agents, and employees for all personal injuries known or unknown which my children may incur by participating in the Child/Youth Program. I, the undersigned, have read this release and understand all terms. I execute it voluntarily and with full knowledge of its significance. Photo/Video Release (Optional - only check if you agree) I (Parent/Guardian) understand that photos and/or videos may be taken during the course of the event. These images will be used for training, publicity and/or fundraising purposes for NMSD. My signature below indicates consent for my children to be photographed and/or videotaped. Field Trip Release (Optional - only check if you agree) (Not applicable for ASL Classes) I (Parent/Guardian) give permission for my children to participate in off-campus field trips with the CECT Child/Youth Program. All field trips will be within walking distance of NMSD and parents will receive communication regarding places and times of field trips in advance. NAME (PLEASE PRINT CLEARLY) SIGNATURE DATE 2