Society of Women Engineers
Parent Permission, Waiver, Medical History and Locator Form
Dear Parent:
Please read and retain a copy of this Form for your records.
The Children’s Program offers a series of interesting and fun tours for children between 6 and 17 who will be attending the Convention with their parent(s).
PLEASE NOTE: For the safety of all children in the program, any child who fails to acknowledge program supervision will be subject to further action. The tour director may: 1) eject the child from the Children’s Program (fees are non-refundable); 2) allow the child to attend only if accompanied by a parent/full-time adult chaperone; or 3) take other action deemed appropriate at the director’s discretion. The
Houston Convention Committee and SWE are not responsible for children ejected from the Children’s Program.All arrival and departure times are estimates and may be off by 15 minutes. However, parents are required to have their child(ren) at the Day Care Suite by 8:30 am, and pick their child(ren) up from the Day Care Suite by 5:00 pm.
Tours Schedule
Wed. June 17th
7:00 am Day Care Suite opens for check-in and breakfast.
8:30 am Depart Day Care Suite to start loading bus.
8:45 am Bus departs Hyatt bus loading area.
9:20 am Arrive at George Ranch Historical Park.
11:30 am Picnic lunch at the George Ranch Historical Park.
12:30 pm Depart George Ranch.
1:05 pm Arrive Houston Fire Museum.
2:15 pm Depart Houston Fire Museum.
2:30 pm Arrive Museum of Printing History.
4:00 pm Depart Museum of Printing History.
4:15 pm Arrive Hyatt bus unloading area.
4:20 pm Arrive Day Care Suite for parents pick-up by 5:00 pm.
Thurs. June 18th
7:00 am Day Care Suite opens for check-in and breakfast.
8:45 am Depart Day Care Suite to start loading bus.
9:00 am Bus departs Hyatt bus loading area.
9:45 am Arrive Space Center Houston.
12:30 pm Lunch at Space Center Houston.
3:45 pm Depart Space Center Houston.
4:30 pm Arrive Hyatt bus unloading area.
4:35 pm Arrive Day Care Suite for parents pick-up by 5:00 pm.
Fri. June 19th
7:00 am Day Care Suite opens for check-in and breakfast.
8:45 am Depart Day Care Suite to start loading bus.
9:00 am Bus departs Hyatt bus loading area.
10:00 am Arrive Sea Center Texas.
12:00 pm Depart Sea Center Texas (box lunches served on the bus).
1:00 pm Arrive Museum of Health & Medical Science.
3:00 pm Depart Museum of Health & Medical Science.
3:05 pm Arrive Children’s Museum of Houston.
4:15 pm Depart Children’s Museum of Houston.
4:30 pm Arrive Hyatt bus unloading area.
4:35 pm Arrive Day Care Suite for parents pick-up by 5:00 pm.
Sat. June 20th (bring your swim suit and a towel today!)
7:00 am Day Care Suite opens for check-in and breakfast.
8:45 am Depart Day Care Suite to start loading bus.
9:00 am Bus departs Hyatt bus loading area.
9:15 am Arrive Cockrell Butterfly Center.
10:00 am Walk next door to Houston Museum of Natural Science.
12:00 pm Walk across street for picnic lunch in Hermann Park.
1:00 pm Depart Hermann Park.
1:15 pm Arrive Hyatt bus unloading area.
1:20 pm Arrive Day Care Suite - change into swim suits.
1:45 pm Walk to Hyatt pool.
4:00 pm Return to Day Care Suite for parents pick-up by 5:00 pm.
6:30 pm Arrive Day Care Suite for a pizza party, Story Teller and rental movie.
9:30 pm Parents pick-up.
Parent Permission and Waiver Form
This form must be completed and presented to the tour director before your child will be allowed to participate in the Children’s Program. Please present it at the time your child checks-in at the Day Care Suite on the first morning for which your child is registered to participate in a tour. Use a separate form for each child.
My child, ____________________________ (full name) has my permission to participate in the tours described on previous pages of this document and will be responsible for her/his own equipment. I will ensure that my child does not attend if she/he is not feeling well.
In case of accident or sickness, the tour director has my authorization to secure medical attention for __________________________ (full name) as deemed necessary. This authorization applies for any medical attention and the charges are covered by myself.
Specifically, my child ___________________________(full name) has my permission to attend the daily tours described previously in this document:
Wed. June 17th, 1998 Signature: _______________________ Date: __________
Thurs. June 18th, 1998 Signature: _______________________ Date: __________
Fri. June 19th, 1998 Signature: _______________________ Date: __________
Sat. June 20th, 1998 Signature: _______________________ Date: __________
In consideration of my child’s acceptance in the Children’s Program, I waive and release any and all claims for myself and my heirs against the Society of Women Engineers, Convention volunteers and any other person associated with the Children’s Program, for any injury, illness or death which may result from my child’s participation in the Children’s Program. My claims remain waived even though liability may arise out of negligence or carelessness on the part of persons or entities mentioned above. I hereby grant full permission for any publicity and/or promotional purposes without obligation or liability to me.
Parent Name (please print): ________________________________________
Signature: ________________________________
Hotel reservation at: ________________________ Room Number: _________
Medical History Form
This form must be completed and presented to the tour director before your child will be allowed to participate in the Children’s Program. Please present it at the time your child checks-in at the Day Care Suite on the first morning for which your child is registered to participate in a tour. Use a separate form for each child.
Child’s Name: ___________________________________
Past Illness: Allergies: Other:
____ Ear problems ____ Hay Fever ____ Fainting
____ Convulsions ____ Insect stings ____ Contact lenses
____ Asthma ____ Drugs (specify) ____ Diabetes
____ Heart disease ________________ ____ Nose bleeds
____ Food (specify) ____ Heat stroke
________________ ____ Other (specify)
_________________
Date of last tetanus shot: _____________
Currently taking the following medications: ___________________________________
Medical Insurance Policy # : ________________ Insurance Co. _________________
Physician’s name and phone number: _______________________________________
Parent Locator Form
This form must be completed and presented to the tour director before your child will be allowed to participate in the Children’s Program. Please present it at the time your child checks-in at the Day Care Suite on the first morning for which your child is registered to participate in a tour. If you have more than one child registered in the Children’s Program, include all of their names on this form. This form will be delivered to the SWE Concierge prior to the tour bus departure, should you need to be notified in case of an emergency or change in program.
Parent Name (please print): _____________________________________________
Hotel reservation at: ___________________________ Room Number: __________
Children’s Names (give last names also, if different):
Please use the space below to provide any other information (cell phone number, pager, etc.) that will assist us in locating you, should it become necessary.