continuing s education · take your game design skills to the next level by creating and animating...

ContinuingEducationF O R A B E T T E R L I F E

SUMMER 2020 CLASSES

WWW.UCC.EDU/CE

Youth

Programs

Classes begin

June 8

Improve Your Skills! Learn Something New!

ALL CLASSES OFFERED THROUGH REMOTE INSTRUCTION

The SATs were postponed,

preparing your child to take them shouldn’t be.SAT Exam Preparation Learn important test-taking strategies and prepare to take the upcoming SAT exam. Specific concepts covered include math, verbal and writing. Students need to purchase the Official SAT Study Guide 2020 Edition ISBN# 9781457312199. Ages 14+

VERBAL/READING/WRITING AEKD 211 Sec 19A M-Th, 7/20-8/13, 1-2:30 pm, $329

MATH AEKD 107 Sec 19A M-Th, 7/20-8/13, 2:40-4:10 pm, $329

2 UNION COUNTY COLLEGE • CONTINUING EDUCATION • SUMMER 2020 CLASS OFFERINGS

THIS CLASS WILL BE OFFERED THROUGH REMOTE INSTRUCTION USING CANVAS

908-709-7600 • WWW.UCC.EDU/CE • TO REGISTER USE FORM ON PAGE 8 3

Youth Programs for Summer 2020

All classes are offered through remote instruction and require computer access.

We are pleased to partner with Black Rocket to deliver educational and fun classes designed to mirror real experiences and the collaborative nature of the creative process. Students will work in

pairs or teams for most of the programs.

BLACK ROCKETAll of these courses are for students ages 11-14.

3D Game Design with UnityAre you ready to take your game design skills to another level? With Unity, an industry-grade design software, aspiring game designers will learn level editing, 3D modeling, impactful gameplay creation, as well as how to utilize scripts and variables. Student-created games will be available on a password protected Black Rocket website to share with friends and family. Students will work in pairs or teams for most of the program. Returning students can create more advanced projects that build on previous years. (15 hrs)

*This requires a 64-bit operating system. *Compatible with MAC and Windows OS only.

AEKE 04A 091 M-F, 6/29 - 7/3 1:30 - 4:30 pm, $179AEKE 04A 09A M-F, 7/13 - 7/17 1:30 - 4:30 pm, $179

App Attack!Take the first steps into the world of mobile app design and customize your own game app! Using a specialized app & game development tool, students will explore the world of web-based (HTML5) mobile apps. In addition to learning the basics of mobile app design and game development, you will also see firsthand how the world of App publishing functions. Student-created apps will be accessible on a private site and can be played on any mobile device or computer. Publishing to App Stores not included. Students do not need to own a smartphone or tablet to take this class. Returning students can create more advanced projects that build on previous years. (15 hrs) *Compatible with Windows OS only.

AEKE 816 Sec 091 M-F, 6/29- 7/3 1:30 - 4:30 pm, $179

App.IO: Make Your First Multiplayer App!The hottest new Apps are IO apps! If your child likes to play Agar.io or Slither.io they will love this class! Become the creator of the next viral web app! In this class, explore the most popular .IO apps, design your own multiplayer experience and learn how to code your own app. Student-created apps will be accessible on a private site and can be played on any mobile device or computer. Publishing to App Stores not included. Students do not need to own a smartphone to take this class. Students will work in pairs or teams for most of the program. Returning students can create more advanced projects that build on previous years. *Compatible with Windows OS only. (15 hrs)

AEKE 032 091 M-F, 8/17- 8/21 1:30 - 4:30 pm $179

Battle Royale: Make Your First Fortnite ® Style Video GameFans of Fortnite we need you! Instead of playing the game, design your own. Using a professional 3D game development software, build levels and assets inspired by popular battle royale games like Fortnite. Students can participate in eSports League matches against other schools across the country with a chance to have their levels featured in the Black Rocket master build of the game! This course includes cartoonish action and battle sequences. Student-created games will be available on a password protected Black Rocket website to share with friends and family. Students will work in pairs or teams for most of the program. *This requires a 64-bit operating system. *Compatible with MAC and Windows OS only. (15 hrs)

AEKE 039 Sec 091 M-F, 6/8 - 6/12 1:30 - 4:30 pm, $179 AEKE 039 Sec 09A M-F, 8/3 - 8/7 1:30 - 4:30 pm, $179

Code BreakersCalling all future coders, programmers, & designers! Learn the basics of coding languages like HTML, JavaScript, and CSS through a series of web projects and design challenges each day and be on your way to becoming the next tech star! Whether you want to be a silicon valley CEO or the high school student who just made $1 million dollars for programming in

her bedroom, this course has the essentials you need to begin your journey. Projects will be available on a Black Rocket website to share with friends and family. Students will work in pairs or teams for most of the program. Returning students can create more advanced projects that build on previous years. (15 hrs)

AEKE 305 Sec 090 M-F, 6/15 - 6/19 9:30 am - 12:30 pm, $179AEKE 305 Sec 09A M-F, 7/6 - 7/10 9:30 am - 12:30 pm, $179AEKE 305 SEC 09B M-F, 8/10 - 8/14 9:30 am - 12:30 pm, $179

Code Your Own Adventure! Interactive StorytellingWatch as the characters in your imagination come to life in this unique course that blends classic storytelling with animation techniques and coding. Start with a concept, design the characters, and choose not just one ending, but many! Learn how to create your own text-based adventure games with variables, conditional logic, images, HTML, CSS, and JavaScript. Student projects will be available on a password protected Black Rocket website to share with friends and family. *Compatible with MAC and Windows OS only. (15 hrs)

AEKE 053 Sec 091 M-F, 7/27 - 7/31 1:30 -4:30 pm, $179



eSports Apprentice - Streamers and GamersWhether you want to be the next pro gamer, streamer, or gamecaster this course will teach you the basics to get started! No longer just a hobby, eSports is the fastest-growing career for the next generation. Over 400 million people watched YouTube videos and Twitch streams of video game competitions this year alone! In this course, students will develop game-play skills and compete using Black Rocket’s eSports games and apps, learn how to produce commentary for live tournaments, use professional streaming software, and most importantly practice online safety. Student recordings will be available on a password protected website to share with friends and family. Videos will not be broadcast publicly but will be shared with all students in the class. *A webcam is required for this course. Software is compatible with MAC and Windows OS only. (15 hrs)

AEKE 01A Sec 090 M-F, 6/22 - 6/26 9:30 am - 12:30 pm, $179AEKE 01A Sec 09A M-F, 8/17 - 8/21 9:30 am - 12:30 pm $179

NEW!Inventor’s League - Prototyping for the Future!Become an inventor of the future! Learn ‘rapid prototyping’ and problem solving as you conceptualize and design a product to solve a critical global issue. Each day begins with inspirational profiles of young inventors, such as the eleven-year-old who coded a robot to find victims of natural disasters. Next, research a problem to tackle in medicine, architecture, the environment, or a topic of your choosing. Once your vision is complete, learn how to draft 2D designs, create 3D models, and develop a website to pitch your ideas to the class. Student

projects will be available on a password protected Black Rocket website to share with friends and family. *Compatible with MAC and Windows OS only. (15 hrs)

AEKE 051 Sec 091 M-F, 7/6 - 7/10, 1:30 - 4:30 pm, $179 AEKE 051 09A M-F, 7/20 - 7/24, 1:30 - 4:30 pm, $179

JavaScript Developer JamLearn programming tools so powerful they seem like magic! Start off by learning an array of core programming concepts with JavaScript by experimenting in a series of digital challenges. Start with programming your first animated memes, and then tackle more advanced skills such as interactive 3D experiences and game creation. Projects will be available on a password protected Black Rocket website to share with friends and family. *$10 license fee per student with this class. (15 hrs)

* Compatible with MAC, Windows and Chrome OS.

AEKE 309 Sec 091 M-F, 6/8 - 6/12 1:30 pm - 4:30 pm, $179AEKE 309 Sec 090 M-F, 6/29 - 7/3 9:30 am - 12:30 pm, $179AEKE 309 Sec 09A M-F, 8/24 - 8/28 9:30 am - 12:30 pm, $179

Make Your First Video Game! If you love playing video games, this is the camp for you! Make your first video game in this one-of-a-kind class that shows you the keys to designing your first 2D platformer game. Conceptualization, play experience, level design, graphics, sounds, and simple coding are just some of the concepts that we’ll explore. No prior experience necessary, just a desire to have fun. Student projects will be available on a password protected Black Rocket website to share with friends and family. Games are only compatible on PC computers, Mac versions can be created after the program for $15.00 conversion fee. Returning students can create more advanced projects that build on previous years. *Compatible with Windows OS only. (15 hrs)

AEKE 914 Sec 091 M-F, 6/22 - 6/26 1:30 - 4:30 pm, $179AEKE 914 Sec 09A M-F, 8/24 - 8/28 1:30 - 4:30 pm, $179

Make Your First 3D Video Game!In this Black Rocket classic, you will go well beyond the limitations of the traditional 2D game design classes and create an immersive 3D world. Students will learn the physics behind 3D games, explore beginner event scripting, level design, controlling the flow of gameplay, and storytelling. Student projects will be available on a password protected Black Rocket website to share with friends and family projects are only compatible with Windows devices. *Compatible with Windows OS only. (15 hrs)

AEKE 946 Sec 090 M-F, 7/27 - 7/31 9:30 am - 12:30 pm, $179

Minecraft® AnimatorsCreate the next popular animated Minecraft video on YouTube! Practice the same skills professionals at Pixar and Disney Animation Studios use. Discover the process of keyframing and tweening, how to use it to bring your own animated stories to life, and how to publish your content on YouTube. Student projects will be available on a password protected Black Rocket website to share with friends and family. Mac users can play their project at home, but will not be able to edit the project without a PC. Returning students can create more advanced projects that build on previous years. *Compatible with Windows OS only. (15 hrs)

AEKE 917 Sec 090 M-F, 7/13 - 7/17 9:30 am - 12:30 pm, $179AEKE 917 Sec 09A M-F, 8/24 - 8/28 9:30 am - 12:30 pm, $179



Minecraft® Designers If you love the game Minecraft and always wanted to design your own world, this class is for you! Learn how to create a custom map, the basics of creating 3D models using a new software to design your very own objects, how to build with Redstone and Command blocks, and create custom textures for you to import at home or share with friends. Students must own a Java version of Minecraft to take this class. Tablet, phone, and game console versions of Minecraft are not compatible. Parent email address is required to use 3D modeling software. Returning students can create more advanced projects that build on previous years. *Compatible with MAC and Windows OS only. Purchase Minecraft Java Edition. (15 hrs)

AEKE 304 Sec 091 M-F, 7/20 - 7/24 1:30 - 4:30 pm, $179AEKE 304 Sec 090 M-F, 8/17 - 8/21 9:30 am - 12:30 pm, $179

Minecraft® Modders Use your favorite game to learn the basics of modding and foundations of programming. Learn scripting and logic statements as you create your first mods! Introductory coding will also be taught through a simulated environment inspired by Minecraft. Student projects will be available on a password protected Black Rocket website to share with friends and family. Students must own a Java version of Minecraft to take this class. Tablet, phone, and game console versions of Minecraft are not compatible. Returning students can create more advanced projects that build on previous years. *Compatible with MAC and Windows OS only. Purchase Minecraft Java Edition. (15 hrs)

AEKE 306 Sec 091 M-F, 6/15 - 6/19 1:30 - 4:30 pm, $179AEKE 306 Sec 09A M-F, 7/27 - 7/31 1:30 - 4:30 pm, $179

NEW!Minecraft® Redstone EngineersTake the next step beyond simply “playing” Minecraft and become a true Redstone engineer. Expand your Redstone knowledge by constructing your own carnival with a variety of mini-games, roller coasters, and attractions powered by Redstone. Learn how to use Command and Structure blocks to incorporate them into your builds. Activate your skills and take your Minecraft structures to the next level! Students must own a Java version of Minecraft to take this class. Tablet, phone, and game console versions of Minecraft are not compatible. *Compatible with MAC and Windows OS only. Purchase Minecraft Java Edition. (15 hrs)

AEKE 009 Sec 090 M-F, 6/8 - 6/12 9:30 am - 12:30 pm, $179 AEKE 009 Sec 09A M-F, 7/6 - 7/10 9:30 am - 12:30 pm, $179 AEKE 009 Sec 091 M-F, 8/10 - 8/14 1:30 - 4:30 pm, $179

NEW! Pokémon® Masters: Designers & 3D Makers Unite!Calling all boys and girls who want to be the designers of the future! In this class, if you can dream it, you can make it! Begin by creating your own digital Pokemon-style custom playing card game and progress onto designing action figures, jewelry, and toys in professional-level modeling software. Learn how to prepare a model for 3D printing and create a design portfolio to showcase your work! No prior experience is necessary and 3D designs will be available on a password protected Black Rocket website to share with friends and family. *This is a limited release only available for BR Instructor Creator Corps Schedules. *Compatible with MAC and Windows OS only. (15 hrs)

AEKE 052 Sec 090 M-F, 7/13 - 7/17 9:30 am - 12:30 pm, $179 AEKE 052 Sec 091 M-F, 8/24 - 8/28 1:30 - 4:30 pm, $179

Python Programmers Want to learn the world’s fastest-growing programming language favored by Google, NASA, Youtube, and the CIA? Learn how to code with Python to create engaging apps and games. Each lesson takes you step-by-step on a programming path that will let you challenge friends with fun content you create from start to finish! Returning students can create more advanced projects that build on previous years. *$10 license fee per student with this class. *Compatible with MAC, Windows and Chrome OS. (15 hrs)

AEKE 011 Sec 090 M-F, 6/22 - 6/26 9:30 am - 12:30 pm , $179AEKE 011 Sec 091 M-F, 7/13 - 7/17 1:30 - 4:30 pm, $179 AEKE 011 Sec 09A M-F, 8/3 - 8/7 1:30 - 4:30 pm, $179

ROBLOX® Coders & Entrepreneurs!Discover how to code in the Lua language while playing and designing worlds in ROBLOX®, an online universe where you can create anything you dream of. This new class combines game design concepts, coding, and fun! Young entrepreneurs will also learn how to navigate ROBLOX’s fast-growing marketplace to publish their games. Student-created games will be available on a password protected Black Rocket website to share with friends and family. *$10 license fee per student with this class. (15 hrs)

*Compatible with MAC and Windows OS only.

AEKE 010 Sec 090 M-F, 6/15 - 6/19 9:30 am - 12:30 pm, $179 AEKE 010 Sec 09A M-F, 7/27 - 7/31 9:30 am - 12:30 pm, $179




ROBLOX® MakersUnlock the power of ROBLOX® Studio, the world creation tool used by real-world ROBLOX® developers! Learn how to build 3D models and create an adventure in your ROBLOX® world. Bring characters to life with unique animations you design. Student-created projects will be available on a password protected Black Rocket website to share with friends and family. *Compatible with MAC and Windows OS only. (15 hrs)

AEKE 038 Sec 090 M-F, 6/8 - 6/12 9:30 am - 12:30 pm, $179AEKE 038 Sec 091 M-F, 7/6 - 7/10 1:30 - 4:30 pm, $179AEKE 038 Sec 09A M-F, 8/3 - 8/7 9:30 am - 12:30 pm, $179

NEW! Rocket Kart Racers: Design A Mario Kart® Style GameOn your marks, get set, create! Blast off in making your first 3D Mario Kart® and Crash Team Racing® style game! Design your own tracks and customize your karts and characters. Using a professional 3D game development software, students will combine their creations into their own kart racing game that they can play with friends and family at home. Students can participate in eSports League races against other schools across the country with a chance to have their tracks featured in the Black Rocket master build of the game! Student projects will be available on a password protected Black Rocket website to share with friends and family. *This requires a 64-bit operating system. *Compatible with MAC and Windows OS only. (15 hrs)

AEKE 012 Sec 091 M-F, 6/22 - 6/26, 1:30 - 4:30 pm, $179 AEKE 012 Sec 090 M-F, 7/20 - 7/24 9:30 am - 12:30 pm, $179 AEKE 012 Sec 09A M-F, 8/10 - 8/14 9:30 am - 12:30 pm, $179

Video Game Animation Take your game design skills to the next level by creating and animating your own character sprites, objects, and backgrounds. Start with a name, develop the character’s personality, signature moves, special powers, and a storyline. Finish with a fully animated character to be used in your very own game. Students do not need any prior experience in game design, animation, or sketching. Student-created games will be available on a password protected Black Rocket website to share with friends and family. Games are only compatible on PC computers; Mac versions can be created after the program for $15.00 conversion fee. Returning students can create more advanced projects that build on previous years. *Compatible with Windows OS only. (15 hrs)

AEKE 514 Sec 091 M-F, 6/15 - 6/19 1:30 - 4:30 pm, $179 AEKE 514 Sec 090 M-F, 8/3 - 8/7 9:30 am - 12:30 pm, $179

NEW! YouTube® Content CreatorsFind your voice and leave your mark on the world! Whether you are six or sixty, it’s time to start a career as the next YouTube star. Explore the variety of content and personalities that exist on YouTube and how to find your own niche. Learn the Dos and Don’ts of the platform and how to practice good digital citizenship. Develop your on-camera presence, your own channel branding, and professional editing skills. Take home a plan for launching your own channel with the content created in class! Student projects will be available on a password protected Black Rocket website to share with friends and family. *A webcam is required for this course. *Compatible with MAC and Windows OS only. (15 hrs)

AEKE 048 Sec 090 M-F, 6/29 - 7/3 9:30 am - 12:30 pm, $179AEKE 048 Sec 091 M-F, 8/10 - 8/14 1:30 pm - 4:30 pm, $179

SUPER SCIENCEEach challenge STEAM lesson will be delivered through YouTube video instruction by Dan Weissman. Students will receive a package of supplies for this program by first class mail. The class can be completed at the student’s own pace and at any time they wish. Super Science will offer live customer support by certified teachers via phone, email, and face time daily, M-F June 22- August 14, 2020, between the hours of 8:30 a.m. and 2:30 p.m. Ages 11-13.

NEW! STEAM Challenges In this engineering camp, you will have fun integrating Science, Technology, Engineering, Art, and Mathematics by building and designing a wide range of gadgets, inventive machines, towers, crazy contraptions, and more...all from the comfort of your own home! Projects include: The Great Tower Challenge, Wooden Coaster Challenge, Structural Engineering Challenge, Magnificent Marble Machine, and a host of other fun contests designed to bring out the engineer in you! (15 hrs)

AEKE 029 Sec 090, $139

Junior Physicians - Discovering the Human BodyDiscover the anatomy of the world’s most complicated system - the human body...from the privacy of your own home! In this program, kids will find out what it’s like to journey through the human body. We will explore each of the different systems of the human body through hands-on experimentation. Activities include simulated blood typing, making Mr. Skeleton, making a map of the human tongue, a model heart,



Youth Programs for Summer 2020brain, and more. Students will also perform computer-operated simulated surgery through a password-protected website. (15 hrs)

AEKE 027 Sec 090, $139

NEW!Make & Take - Toys that TeachMake your own working telescope as you learn about the optics of light. Construct an electro-magnet and a working electric motor. Build an adjustable, ball-launching catapult that changes the trajectory of a flinging projectile. Create a working model of Hero Alexandria’s fountain or vortex tornado in a bottle. Make ultra-violet bead bracelets, a working compass, submarine divers, and more. (15 hrs)

AEKE 054 Sec 090, $139

Chemical WizardryGet ready for a fun-filled “magical” laboratory experience Harry Potter style... from the comfort of your own home! This class is an introduction to the science of chemistry. In addition to learning about atoms, bonding, and the periodic table, you will enjoy making Flubber, Silly Putty, Super Hi- Bounce balls, and more. Have fun making light inside of a glow bottle, play dough, Glowing Goo, and even a tye-dye style shirt. We will create atomic worm polymers and lava lamp-like blobs. We will also demonstrate the Big Bang Cannon, diet Coke and Mentos Geyser, Magic Genie in the bottle, and more. (15 hrs)

AEKE 026 Sec 090, $139

NEW!Mini Robotics: Sphero and BristleBots Have fun experimenting with mini robots from the privacy of your home! Coding, robotics, art, STEAM, and computer science will come alive with tiny, programmable mini-robots. Learn to use the Sphero

mini app to drive in different modes, program with Javascript, or as a controller to play games. Our instruction will help you to really have fun and learn with your robot. Then have fun using toothbrush motor and vibration technology to build and take home your own “Bristlebot!” * A tablet or phone and the free Sphero Apps are required to take this program. (15 hrs)

AEKE 056 Sec 090, $139

STEM EDUCATION LLC

Rocketry The curriculum for Rocketry will include basic principles of Physics including Newton’s Laws of Motion as they pertain to basic aerodynamics and trigonometry. Students will construct and launch rockets with the help of their online teacher who will include basic principles of physics throughout the lessons. A culminating event will include the launching of the rocket with the help of the instructor. All materials will be provided and sent directly to the student’s home. This class will be conducted using Google Meets. (12 hrs)

Ages 11-13 AEKE 046 190 M-Th, 8/10-8/13 9 am-12 pm, $199Ages 14+ AEKD 046 191 M-Th, 8/10-8/13 1-4 pm, $199

TEST PREP Get a jump on test taking strategies and fundamentals that will enhance your abilities and help improve test scores. All courses are taught by NJ Certified Teachers. (24 hrs)

SAT Exam Preparation Learn important test-taking strategies and prepare to take the upcoming SAT exam. Specific concepts covered include math, verbal and writing. This course will be offered through remote instruction using Canvas. Students need to purchase the Official SAT Study Guide 2020 Edition ISBN# 9781457312199. Ages 14+.

VERBAL/READING/WRITING AEKD 211 Sec 09A M-Th, 7/20-8/13 1-2:30 pm, $329

MATH AEKD 107 Sec 09A M-Th, 7/20-8/13 2:40-4:10 pm, $329

WRITING

The Writer Within: Creative Writing Develop your skills as a creative writer. Learn how to create interesting plots, characters and dynamic conflicts. Whether you enjoy writing short stories, poetry or planning to write a novel, this course will help you hone those creative writing skills. Students will also learn how to e-publish, find a publisher and enter writing contests. Ages 11-14. (24 hrs)

AEKE 235 Sec 090 M-Th, 7/20-7/30 9 am-12 pm, $289AEKE 235 Sec 09A M-Th, 8/10-8/20 9 am-12 pm, $289

MATH

Middle School Math Review This course is designed to review each of the New Jersey Core Curriculum Content math standards for middle school students. Students will review numerical operations, geometry and measure-ment, algebra, data analysis and mathematical processes. Ages 11-13. (24 hrs)

AEKE 117 Sec 090 M-Th, 7/20-7/30 9 am-12 pm, $289

Algebra Review This course addresses the material covered in a middle or high school Algebra course. Through interactive lessons and practice problems, students will strengthen their Algebra knowledge. Students will be pre-tested to determine their proper level and need. Ages 14+. (24 hrs)

AEKD 115 Sec 090 M-Th, 7/20-7/30 9 am-12 pm, $289

YOUTH PROGRAMS REGISTRATION FORM

The Youth Programs Permission Slip (next page) must be completed and returned with this registration form. Print clearly and complete all sections.

STUDENT DATA

Last Name First Name MI

Street Address (including apartment number)

City/Town State Zip Home Telephone

Student ID Number Gender: □ Male □ Female Date of Birth (MM/DD/YYYY)

PARENT/GUARDIAN DATA

Last Name First Name MI

Street Address (including apartment number)

City/Town State Zip Phone □ Home □ Work □ Cell

E-mail Address

CAMPUS PARKING□ I decline campus parking

□ I wish to have a permit for parking in Cranford (Complete the information below and add $10 parking fee)

License Plate Number State Year, Make and Model of Car

You must pick up your parking permit at the Public Safety Office, at which time you will be required to show a current vehicle registration.

COURSE SELECTIONS AND FEES (Please enter your course selections)

Course Code-Number Section Number Course Title Start Date (MM/DD/YY) Course Fee

Parking Fee (if applicable)

TotalOFFICE USE ONLYPay Code____________________________________ Amount ______________

Date ______________________________ Cashier ________________________

Register by email, or call (908) 709-7600 or (908) 709-7601. Continuing Education, Union County College, 1033 Springfield Avenue, Cranford NJ 07016-1599 Phone (908) 709-7600 • Email [email protected]

�� I am financially responsible for all program costs forStudent’s Name

Your Name Address Telephone

Note: Students are responsible for being aware of and following the Code of Conduct found in the Union County College Student Handbook, available at www.ucc.edu/go/handbook.

Have questions about Union County College Youth Programs? Email us at [email protected] County College does not discriminate on the basis of race, color, national origin, sex, age or disability.

CONTINUINGEDUCAT ION

…for a better life

( )

The following questions are required by the U.S. Department of Health, Education, and Welfare, Title VIof the Civil Rights Act. Completion is voluntary.

Sex: □ Male □ Female

Ethnicity: □ Hispanic □ Non Hispanic □ Declined to Identify

Race: □ American Indian/Alaskan Native□ Asian□ Black/African American□ Native Hawaiian/Pacific Islander□ White□ Declined to Identify

Youth Programs Registration Form

Union County College does not discriminate and prohibits discrimination, as required by state and/or federal law, in all programs and activities, including employment and access to its career and technical programs. If you or someone attending with you has a disability and is in need of special accommodations, please contact the Coordinator of Services for Students with Disabilities at (908) 709-7164.

mailto:[email protected]

http://www.ucc.edu/go/handbook

mailto:[email protected]

YOUTH PROGRAMS INFORMATION AND PERMISSION FORM

All Youth Program participants MUST have this form completed by a parent or guardian.

Please print clearly and complete all sections

STUDENT INFORMATION

Full Name: _____________________________________________________________________________________________________________________________Last First Middle Initial

Child’s Age: __________ Current Grade (for Summer students, grade entering in upcoming Fall) _________

Home Phone (with area code): ______________________________

PARENT/GUARDIAN CONTACT INFORMATION

Name: ____________________________________________________________

Preferred Phone: ____________________________________ Alternate Phone: ________________________________

EMERGENCY CONTACT INFORMATIONIf I am not available, I hereby designate the following person(s) to be contacted in an emergency:

Name________________________________________________ Relationship ______________________________ Phone # ______________________________

Name________________________________________________ Relationship ______________________________ Phone # ______________________________

Doctor’s Name __________________________________________________________________ Phone __________________________________________________

Medical Insurance Co ____________________________________________________________ Policy # ________________________________________________

The above named child has the following food allergy(ies) and/or medical condition:

______________________________________________________________________________________________________________________________________

I understand it is the responsibility of the parent/guardian to notify program staff of any change in the above information.

CONTINUINGEDUCAT ION

…for a better life

I, ____________________________________________________, the legalparent/guardian of the above named Youth Programs participant, will:CHOOSE ONLY ONE OF THE FOLLOWING THREE OPTIONS

□ Pick up my child at the conclusion of his/her scheduled course(s) in the designated location on the Union County College Cranford Campus

□ Permit the following individuals to pick up my child at the conclusion ofhis/her scheduled course(s) in the designated location on the UnionCounty College Cranford Campus. No one other than the named personsbelow will be permitted to pick up your child.

Name: __________________________________ Phone: ________________

Name: __________________________________ Phone: ________________

□ Permit my child to leave the campus unattended by Program or Collegestaff at the conclusion of his/her scheduled course(s) on a daily basis.Check this option if you are permitting your child to walk home, ride his or her bike home, take the bus, etc.No supervision is provided and no responsibility for your child is assumed once he or she is dismissed from hisor her last class. Your child will not be permitted to remain on College property or in any campus building ifthis option is checked. I expressly release the College and its agents from any liability that may result from mychild’s use of individual transportation as authorized above.

The Parent or Guardian acknowledges that he or she has read, understandsand approves the following statements:

• I give consent for photographs and/or videos of my child to be used solely for Union County College promotional and/or public information purposes.

• I fully understand that I am releasing the College and its agents and employees of all liability including but not limited to injuries, damages or loss, related to any aspect of my child’s participating in the Youth program.

• I understand that the College is not responsible for lost, stolen or damaged property.

• I understand that in an emergency I will be contacted as soon as possibleat the above phone number(s). If I am not available, I have provided an alternate contact above.

• Should my child require immediate medical attention, I consent to any suchtreatment, including but not limited to, transport and treatment at a hospitalfacility. I fully understand I am legally responsible for any medical expensesfor costs of said treatment.

• College personnel are not permitted to hold or be responsible for adminis-tering any medication.

• I understand the College may suspend or terminate my child from the pro-gram for any reason that is deemed harmful or disruptive to the other partic-ipants or for other just cause. Refunds will not be granted if a child issuspended or terminated.

I have read, understand, and agree to the foregoing information. I authorizeUnion County College staff to take whatever measures are in their estimation,deemed necessary, especially in the event of an emergency. The undersigned,on his/her behalf and on behalf of the named participant, releases UnionCounty College, its directors, officers, employees and agents from all claimsand liability to the undersigned or named child and each of their personalrepresentatives, assigns, heirs and next of kin for any loss or damage, andany claim on account of injury to the person or property of the undersigned ornamed child.

__________________________________________________________________________________________________________________________________________________________________________________________________________________________Parent/Guardian name (print)

__________________________________________________________________________________________________________________________________________________________________________________________________________________________Parent/Guardian Signature

__________________________________________________________________________________________________________________________________________________________________________________________________________________________Date

Union County College does not discriminate and prohibits discrimination, as required by state and/or federal law, in all programs and activities, including employment and access to its career and technical programs.

Youth Programs Information and Permission Form

continuing s education · take your game design skills to the next level by creating and animating...

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