2021 Youth Tour Application

Medical Information

Insurance Information

I, the undersigned parent or guardian of the listed applicant, give my consent for him/her to participate in the Washington, D.C. Youth Tour sponsored by our local electric cooperative, the Colorado Electric Educational Institute (CEEI), and the National Rural Electric Cooperative Association (NRECA). I understand that this participation involves travel within and outside Colorado, and at times my son/daughter may be traveling and/or participating in activities without the direct supervision of a chaperone.

I authorize CEEI and NRECA, through their staff and volunteer chaperones, to secure any medical or other emergency services the said staffs and volunteer chaperones in their reasonable discretion may deem necessary or desirable for my son/daughter during his/her participation in the electric cooperative Washington, D.C. Youth Tour.

I/We hereby release and agree to hold harmless CEEI and NRECA, their officers, members, staffs, and associated organizations together with their heirs, successors, or assigns from any and all causes of action, claims, damages, costs, expenses, compensation, personal injury, property loss, or any other loss or injury related to participation by my son/daughter during his/her participation in the electric cooperative Washington, D.C. Youth Tour.

I hereby grant permission to NRECA and CEEI to use photographs, likeness and/or videotape images of my son/daughter for publicity purposes related to this activity.

WASHINGTON, D.C. YOUTH TOUR CODE OF CONDUCT

• You will be sharing a room with two other students. Please be considerate of your roommates.
• You may decide when to go to sleep each night, but you must be in your room by curfew and be on time each morning.
• Students are not allowed to leave the hotel premises without a chaperone.
• Male students are not permitted in female students’ rooms, nor are female students permitted in male students’ rooms, EVER!
• Smoking, alcoholic beverages, or drugs not prescribed by a medical doctor are NOT allowed at anytime.
• Cell phones, iPods and other types of radio/music are not allowed to be used during Youth Tour activities. They may be used during free time.
• Participants must be clothed properly at all times.
• No destruction of property is allowed. Any damages incurred above and beyond normal wear and tear will be charged to the participant causing the damage.
• Students who cancel their participation after February 28 may be required to cover any non-refundable costs incurred by the cooperative if an alternate cannot be found. If cancellation occurs less than one month prior to the trip, you may be billed the entire cost of the trip.