winners manual - future city competition · 1 2016–2017 future city winners manual 2016–2017...

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1 2016–2017 FUTURE CITY WINNERS MANUAL 2016–2017 www.futurecity.org Each year 6th, 7th, and 8th grade students embark on a transformative experience as they ask and answer the question: How can we make the world a better place? From this simple starting point, teams spend four months imagining, researching, designing, and building cities of the future. Build it Design it Show it 2 5 T H A N N I V E R S A R Y 1992–2017 Winners Manual

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1 2 0 1 6 – 2 0 1 7 F u t u r e C i t y W i N N e r S M a N u a l

2016–2017

www.futurecity.org

Each year 6th, 7th, and 8th grade students embark on a transformative experience as they ask and answer the question: How can we make the world a better place? From this simple starting point, teams spend four months imagining, researching, designing, and building cities of the future.

Build it

Design it

Show it

2 5 TH ANNIVERSA RY1992–2017

2 5 TH ANNIVERSA RY

1992–2017

Winners Manual

Table of Contents

Finals Information:

Event Contacts 1

Key Dates 2

Finals Registration and Travel 3

Hotel Arrangements 4

Transporting Your Model 5

Event Details 6

Family and Friends Registration 7

Finals Schedule 7

Helpful Tools:

Glossary of Terms 9

Educator/Mentor Checklist 10

Optional Tasks Checklist 10

Friends and Family Checklist 11

Required Forms:

Media Waiver 12

Medical Release 13

Congratulations on winning your Regional Competition! We look forward to welcoming you to Washington, DC for the 2017 Finals. There are a number of tasks to complete before then, which are detailed in the following pages – so please read carefully. See you in February!

Maggie DresselProgram ManagerFuture City Competition

Event ContactsFuture City has retained the services of Linder Global Events. They will be the main contact for your hotel and travel needs. The Linder team can be reached at [email protected] or 202-459-0889.

Linder will contact you shortly after your Regional Competition to start planning your team’s trip to Finals.

1E V E N T C O N T A C T S / T A B L E O F C O N T E N T S

Key DatesDate of Finals Finals LocationFebruary 17-22, 2017 Capital Hilton 1001 16th Street, NW Washington, DC 20036

Arrival DatesTo combat jetlag, teams west of the Mississippi must arrive on Friday, February 17, while teams east of the Mississippi must arrive on Saturday, February 18 by 5:00 pm (EST).

Regions to Arrive Regions to Arrive Friday, February 17, 2017 Saturday, February 18, 2017 by 5:00 pm

Arizona AlabamaCalifornia – All CanadaChina Florida – AllEgypt GeorgiaGreat Plains Illinois (Chicago)Idaho IndianaMinnesota IowaNebraska KentuckyNevada LouisianaNew Mexico MichiganOklahoma Mid-AtlanticTexas – All Washington

Future City Finals Calendar SnapshotFEBRUARY 17–22, 2017

Friday Saturday Sunday Monday Tuesday Wednesday

Teams from west of the Mississippi

arrive at the Capital Hilton

Teams from east of the Mississippi

arrive at the Capital Hilton

by 5:00 pm~

Welcome Party(Friends & Family Purchase Tickets)

Model Unpacking & Set-Up

~Special Award

Judging~

Public Viewing of City Models

Model & Presentation

Judging ~

Team Photos~

DC Tour (Friends & Family Reserve Tickets)

Finals & Special Awards Ceremony

~Model Packing

~Celebration Party

Teams depart for home

Departure DateAll teams will depart Washington, DC on Wednesday, February 22, 2017.

New England New JerseyNew York – AllNorth CarolinaOhioPennsylvania – AllSouth CarolinaTennesseeWisconsin

2K E Y D A T E S

February 18 is Discover Engineering Family Day at the National Building Museum! Teams are encouraged to attend this free event. Location: National Building Museum, 401 F St NW, Washington, DC 20001. Hours: 10:00 am – 4:30 pm.

Finals Registration And TravelThere are two tasks to complete within five days of winning your Regional Competition:1. Register for Finals2. Book Travel Reservations

1) Register For FinalsThe first thing to do after winning your Regional Competition is visit www.regpacks.com/futurecityteam to complete the online registration and confirm your team’s participation in Finals. The educator or mentor will submit all relevant team information, including:

• Full name (including middle name or initial) as it appears on a birth certificate or state or government issued picture ID and date of birth for five official team members.

• Required Forms: Competition Expense Form and Honor Statement will be uploaded during the registration process. The Media Waiver and Medical Release will be completed separately by the student’s parent/guardian and submitted by February 3, 2017. Further instructions can be found on page 11.

2) Book Travel ReservationsAfter completing the online registration form, you are ready to make your travel arrangements with Travel Partners, LLC. Future City pays the cost of travel for the five official team members.

Please Note: The educator or mentor must make the travel ar-rangements for the official team. When contacting Travel Part-ners, please mention you are with the Future City Competition.

DEADLINES FOR MAKINg TRAVEL RESERVATIONS:

Teams must finalize travel arrangements within five days of their Regional Competition. Failure to make your reservations by this deadline may result in the forfeiture of your team’s free trip to the Finals.

After your team selects their desired flight option, Travel Partners will email you a copy of your travel itinerary. You must respond to Travel Partners by 5:00 pm (eastern) the same day you receive your travel itinerary to approve it and receive the tickets.

Once the team’s reservations have been made and the travel itinerary has been approved, family members and friends may contact Travel Partners directly to make their own travel arrangements.

Arrange ground Transportation From the Airport1. Reagan National Airport (DCA)

Teams arriving at Reagan National Airport are responsible for the cost of ground transportation. The Capital Hilton does not operate an airport shuttle service. Travel options include:

• TheWashingtonDCMetrosubwaysystemisavailablebetween the airport and the hotel. Visit www.wmata.com for more information.

• TheWashingtonareaSuperShuttleisalsoavailable. Call 1-800-258-3826 or visit www.supershuttle.com.

• Taxicabsareavailabletoandfromtheairportandthehotel.

Additional information may be obtained through www.washington.org (the official tourism site for Washington, DC) and from www.metwashairports.com (the official site for the Metropolitan Washington Airports Authority).

2. Thurgood Marshall Baltimore-Washington International Airport (BWI) OR Washington Dulles International (IAD)

The Future City Competition will reimburse Super Shuttle fees for official team members arriving at the Baltimore or Dulles airports. The reimbursement for Baltimore is $223.20 and $217.80 for Dulles. The team educator will receive this reimbursement check within 4-6 weeks of submitting their receipt and W-9 to Future City HQ. (Please email your receipt and W-9 to [email protected] or bring with you to Finals.) To arrange your transportation through Super Shuttle, visit www.supershuttle.com and enter discount code X64NN.

Teams will fly into one of the following airports:

• RonaldReaganWashingtonNationalAirport(DCA)

• WashingtonDulles(IAD)

• ThurgoodMarshallBaltimoreWashingtonInternationalAirport (BWI)

We will be as accommodating as possible with flights. How-ever, final arrangements will be based on cost and schedul-ing and are at the sole discretion of the Future City HQ Staff.

Travel Partners can be reached at:[email protected] (preferred)1-800-884-0070Hours: Monday–Friday 9:00 am-5:00 pm (eastern)

3F I N A L S R E g I S T R A T I O N A N D T R A V E L

Super Shuttle locations at BWI:Passengers should check in with a SuperShuttle Customer Service Representative available at outer curb pickup zone C1 (across from door #7 in domestic baggage claim) from 8am–midnight 7 days per week. Passengers needing additional assistance may call 1-800-258-3826.

Super Shuttle locations at Dulles International Airport: After collecting your luggage, proceed to the Super Shuttle ticket counters, located on the lower level just before the East and West exits. After purchasing your tickets the shuttle service representative will escort your team to the loading areas at 1D and 1E. Super Shuttle representatives are on site from 6:00 AM to 2:00 AM daily.

Hotel ArrangementsLinder will make hotel reservations for the three official student presenters, educator, and mentor at the Capital Hilton. Please do not contact the hotel to make a room reservation for the five official team members.

If your team chooses to arrive earlier or stay later than the scheduled Finals dates, you are responsible for the cost of the additional nights. You may make your own reservation at the Hilton or make alternate accommodations for those nights that are not paid for by Future City.

OFFICIAL TEAM ROOM ASSIgNMENTS

• Studentteammemberswillbeplacedinroomswithtwodouble beds.

• Theeducatorandthementorwilleachbeplacedinaroom with a king, queen, or two double beds (based on availability). No special room requests can be honored.

• Iftheeducatorandmentoraremarriedtoeachother,theywill be assigned one hotel room.

• Singlegenderteams(e.g.,3boysor3girls)willbeassigned one room with two double beds.

• Mixedgenderteams(e.g.,2girlsand1boy,or2boysand1 girl) will be split based on gender. This may result in the single boy or girl being placed in a room with a student of the same gender from another team. In such instances, the hotel will make every effort to house the two impacted individuals on the same floor and hallway as their teammates.

• Ifateamdoesnotwantastudenttosharearoomwithastudent of the same gender from another team, the team must notify Linder no later than 2 weeks prior to the team’s scheduled arrival in Washington, DC.

• Insuchinstancesthestudentorteam(whoeveristheresponsible party) will pay 50% of the cost of a single room ($184.00 per night + 14.5% tax), which is $105.34 per night (including tax). Future City HQ must receive full payment no later than 1 week prior to the team’s scheduled arrival in Washington, DC.

– Check or credit card (Visa or Master Card only) accepted.

– Payment instructions will be sent via email to the educator with an invoice.

• Uponarrivalatthehotel,theeducatorormentorwillberesponsible for checking in the official team at the Front Desk.

FRIENDS AND FAMILY HOTEL ACCOMMODATIONS

• Iffamilymembers,friends,orstudentteammembersbe-yond the three official presenters, are accompanying the team, they must make their own hotel reservations.

• Familymembersandothersaccompanyingtheteamarewelcome to stay at the Capital Hilton and to take advan-tage of the Future City group rate of $184.00 per night plus tax of 14.5% while room block supply lasts.

• Familymembersandotherattendeesareencouragedto make their reservations for the Capital Hilton online (preferred method) at https://resweb.passkey.com/go/FutureCityFebruary2017 or by calling 1-800-HILTONS code: FCTY. Note: Room availability or rate is not guaranteed and is on a first come, first served basis.

4H O T E L A R R A N g E M E N T S

Transporting Your Model To Finals: Two OptionsOption 1: Ship Model Via Fedex

1. Models must be shipped on February 13 or 14, 2017—NO EXCEPTIONS—directly to the Capital Hilton via FedEx.

Note: All items on the model must be securely attached to prevent damage. If the model is damaged during shipping, repairs will be permitted at the Model Unpacking Session on Sunday, February 19.

2. Linder will send the educator, via email, a FedEx shipping label. The return label for your model will also be sent at this time. Please bring the return label to Finals.

3. FedEx is the only service that may be used to ship your model to Finals. You will need to deliver your model to a FedEx shipping center. A full list of FedEx shipping centers will be included in the email with your shipping labels.

4. Contact your Regional Coordinator for additional tips and advice about shipping your model.

5. It is imperative that teams comply with the following Future City and FedEx shipping requirements and dimensions:

• Themaximumallowableweightlimitforthemodeland shipping container is 75 pounds. If the combined weight of your model and shipping container exceeds 75 pounds you must obtain approval for the additional weight from Linder ([email protected]) prior to shipment. Your team will be assessed the additional shipping charges. If you fail to get permission, your team will be assessed the additional shipping charges and points will be deducted.

• Shippingcontainerscannotbelargerthan30”widex54”longx24”high.

• Wooden shipping containers may not be used.

• Pleaseuselightweightpackingmaterialtominimizedamage to your model during shipment. No packing peanuts are allowed. They make a big mess when unpacking boxes and the hotel charges extra to clean them up. If the model is damaged during shipping, teams may make repairs during the Model Unpacking session on Sunday, February 19. Teams are responsible for bringing all necessary supplies for repairs.

Option 2: Drive Model To Finals

1. If the team elects to drive the model to Washington, DC rather than shipping it, please inform Linder.

2. Teams driving their model will receive a $100.00 travel stipend.

3. Parking fees are not reimbursed. There are a number of parking garages in the area surrounding the hotel with varying daily rates.

4. Prior to arrival, Linder will email instructions to the educator regarding where to bring the model upon arrival at the hotel.

5T R A N S P O R T I N g Y O U R M O D E L T O F I N A L S

Event Details Dress Code 1. The dress code is casual.

2. Future City nametags and T-shirts will be provided to the official team members at Official Team Registration in DC. (Competition T-shirts will be available for purchase for Friends & Family.)

3. All attendees are required to wear their nametags during all Finals activities.

4. Comfortable shoes are suggested for Special Award Judging.

5. If a team is invited to a government facility, each attendee will need to provide his/her Social Security Number or, if not a US citizen, their Country of Birth. Please ensure that your child knows this information.

Meals And Events1. Welcome Party on Saturday, February 18

from 6:30 – 8:00 pm

Celebrate Future City’s 25th Anniversary as we kick-off the 2017 Finals! Learn about the schedule, enjoy a delicious dinner, meet fellow Future City participants, and get ready to have some fun! Educators and mentors will be recog-nized for their dedication to the program.

This event is open to all team members, classmates, family and friends. Attendance is mandatory for the five official team members.

Note: Tickets for family and friends can be purchased online for $10 per person as part of the online registration process. (See page 7 for registration information.) No tickets will be available on-site.

2. Model Unpacking Session on Sunday, February 19 from 9:00 am – 1:00 pm

A box lunch will be provided to the five official team members. Note: All team members are allowed to help unpack their model, but we may limit the number of people allowed into the room at one time based on space.

3. Special Award Judging on Sunday, February 19 from 2:00 – 5:00 pm

NEW in 2017: The three students who represent the team during Special Award judging do not need to be the three official presenters who participate in the City Model

and Presentation judging. Please note that the three presenters for Special Award judging must participate in the entirety of the judging; students may not be switched out or replaced during the judging.

4. D.C. Bus Tour on Monday, February 20 from 2:30 – 5:30 pm

Join us for the Washington Highlights Tour, sponsored by Bentley Systems! Attendees will see DC’s national monuments and federal buildings, from the dome of the U.S. Capitol to the breathtaking view from Lincoln Memorial. Step off the coach bus to visit the Martin Luther King Jr. Memorial, the Jefferson, Lincoln, Korean War, World War II and FDR Memorials, and the Marine Corps Memorial (Iwo Jima). View from coach: The U.S. Capitol, House and Senate Office Buildings, Federal Triangle, Pennsylvania Avenue, The White House, and the Capitol Reflecting Pool. (Note: the tour is subject to change due to weather or other circumstances.)

The bus tour is open to all with a reservation. Official team members will register as part of Official Team registration. Family and Friends can register for this free event online as part of their registration process. No tickets will be available onsite. Buses are filled to capacity on a first-come, first-served basis. Seats cannot be held for late team members.

5. Finals & Special Awards Ceremony on Tuesday, February 21 from 8:30 am – 12:30 pm

The top 5 teams will compete for the title of Finals Champions and Special Award winners will be announced.

A box lunch will be provided to the five official team members immediately following the Finals.

Note: seating in the front of the ballroom will be reserved for student team members.

6. Celebration Party, on Tuesday, February 21 from 7:00 – 9:30 pm

Sponsored by Ohio University, this event is open to all. Come join the fun with caricaturists, face painters, souvenir photos and a jammin’ DJ! Fun snack foods will be provided.

*All other meals are the responsibility of the participants.

City Square City Square is a designated area for all team members to interact with other teams, meet new friends, and hang out during down times. Future City merchandise will be available for purchase at the City Square during specified times throughout the event.

6E V E N T D E T A I L S

Date Time Activity Meeting Room

Saturday 2/18/17

8:00 am – 5:00 pm Registration & Welcome TableSenate: Official Team Registration*Upper Lobby: Friends & Family Registration

Senate Upper Lobby

8:00 am – 6:30 pm City Square: Team Lounge & Future City StoreOpen to All

Federal B

6:30 pm – 8:00 pm Welcome Party Mandatory for Official Team Family & Friends welcome with pre-purchased tickets

Presidential Ballroom

Sunday 2/19/17

9:00 am – 1:00 pm Model Unpacking & Set Up—Team Members Only Congressional and Senate

10:30 am – 12:00 pm Regional Coordinator MeetingThis session is limited to Future City Regional Coordinators

Federal A

9:00 am – 4:00 pm Family & Friends Registration & Welcome Table Upper Lobby

12:00 pm – 1:30 pm Box Lunch Box lunches will be provided to Official Team

Capital Terrace

1:30 pm – 2:00 pm Special Award Judges Briefing Federal A

1:30 pm – 2:00 pm Special Award Educator & Mentor BriefingMandatory for official team educators and mentors.

Presidential Ballroom

2:00 pm – 5:00 pm Special Award Judging Mandatory for three Special Award presenters.

Congressional and Senate

5:00 pm – 10:00 pm City Square: Team Lounge & Future City Store Open to All

Federal B

6:00 pm – 7:00 pm Public Viewing of Models Open to all. Be sure to cast your vote for the People’s Choice Award!

Congressional and Senate

7:00 pm – 9:00 pm Mentor & Regional Coordinator Networking EventMentors & Regional Coordinators OnlySponsored by Bentley Systems

Off-site

2017 Finals ScheduleSubject to change*Official Team = 3 presenting students, 1 educator, and 1 mentor

Family & Friends Event RegistrationRegistration is required for anyone planning to attend the 2017 Finals. We encourage classmates, family and friends to attend the Finals and cheer on their team!

1. Registerforthe2017Finalsat:www.regpacks.com/futurecityfamilyandfriends.Clickon“Family&FriendsRegistration” to register.

2. Name badges for those who have registered will be available for pick-up at the Family & Friends Registration & Welcome Desk on Saturday February 18, Sunday February 19, and Monday February 20.

The deadline for family and friends to register to attend the 2017 Finals is February 3, 2017.

7F A M I L Y & F R I E N D S E V E N T R E g I S T R A T I O N / 2 0 1 7 F I N A L S S C H E D U L E

Date Time Activity Meeting Room

Monday 2/20/17

7:30 am – 8:15 am Judges Briefing Federal A

8:30 am – 2:00 pm Judging Family & Friends may watch only their team’s presentation

California, Ohio, New York, Massachusetts, Statler A, Statler B

8:30 am – 3:00 pm Family & Friends Registration & Welcome Table Upper Lobby

9:15 am – 2:00 pm Team Photos Official Team and all team members

Capital Terrace

2:30 pm – 5:30 pm DC Tour Open to All with Reservations

Meet in Lobby

6:00 pm – 8:00 pm Regional Coordinators DinnerRegional Coordinators and Guests Only

Off-siteMeet in Lobby

7:00 pm – 10:00 pm City Square: Team Lounge & Future City StoreOpen to All

Federal B

Tuesday 2/21/17

7:00 am – 1:30 pm Press Registration & Welcome Table Upper Lobby

7:30 am – 8:15 am Finals Judges Briefing Federal A

8:30 am – 12:30 pm Finals & Special Awards Ceremony Open to All

Presidential Ballroom

12:30 pm – 1:45 pm Team Lunch Box lunches will be provided to Official Team

Federal A

12:45 pm – 3:00 pm Model Packing Open to All

Presidential Ballroom

7:00 pm – 9:30 pm Celebration Party Open to All Sponsored by Ohio University

Presidential Ballroom

Wednesday 2/22/17

All Day Teams Depart for Home

82 0 1 7 F I N A L S S C H E D U L E

Glossary Of Terms1. Official Team: The official five member team consists of

three student presenters, one educator, and one mentor. Certain events at Finals are limited to the Official Team. Additional team members are welcome to attend Finals and should register as Friends and Family. They may participate in many parts of Finals, outlined in the Finals Schedule on Pages 7–8.

2. Alternate: In the event of a medical/family emergency, the student alternate, as designated in the online Future City Teacher Center, will be allowed to substitute for one student presenter at the Finals. Documentation substantiating the emergency must be provided to both the Regional Coordinator and to Future City HQ. Upon approval, Future City will pay expenses for the alternate’s trip to Washington, DC. The deadline to submit a request to substitute the alternate to serve on the official team is February 1, 2017. Note: If the designated alternate would like to attend the event even though all members of the official team will be in attendance, the alternate should register with Friends and Family.

3. Friends and Family: Friends and family are the classmates, parents, siblings and friends of the official team members, as well as the non-presenting members of the Future City competing teams, including alternates. These include the students selected to participate in the Special Award judging, if they are not also the official team presenters. Friends & Family are welcome to attend most events taking place during the Finals Competition. Friends and family should register to attend Finals by February 3 via www.regpacks.com/futurecityfamilyandfriends. Friends and family must pre-register to attend the Welcome Party (tickets for purchase) and the Bus Tour (free with advance reservation). Please use the link above to purchase your tickets in advance.

4. Judges: Judges are professionals in the fields of science, math, technology, engineering, and city design/management who have volunteered their time to review Future City team deliverables. They will review your Virtual City slideshow, read your City Essay, and evaluate your City Model and Presentation. Their scores will determine the Top 5 teams who will compete during the Finals Ceremony on February 21. You will meet the Model and Presentation judges on Monday, February 20!

5. Special Award Judges: Special Award judges are representatives from engineering societies that are sponsoring a Special Award. You can find the list of these awards on page 84 of your Future City Program Handbook or on Future City’s website (http://futurecity.org/awards). Judges will spend five minutes with each team on Sunday, February 19 to determine the winner of their society’s award.

6. Finals Judges: Finals Judges will join us on Tuesday, February 21 for the Finals Ceremony. They will see the models and hear the presentations from the Top 5 teams. Their scores, combined with the Finals scores from the Virtual City and City Essay deliverables, will determine the Champions.

9g L O S S A R Y O F T E R M S

Future City Competition 2017 Official Team Educator/Mentor Checklist

COMPLETE? TASK DUE DATE

Win Regional Competition

Complete and submit the Official Team Online Registration Form: www.regpacks.com/futurecityteam

Within 5 days after your Regional Competition

Make travel arrangements for the official teamthrough Travel PartnersEmail: [email protected]: 1-800-884-0070Hours: Monday–Friday 9:00 am – 5:00 pm (eastern)

Must finalize within 5 days of Regional Competition. You must respond to Travel Partners by 5:00 pm the same day you receive your travel itinerary to confirm.

Ensure parent/guardian of each official team member submits Media Waiver and Medical Form.

February 3, 2017

Ship Model via FedEx. Linder will email you a shipping label and return label. Keep the return label and bring it with you.

MUST Ship on February 13 or 14

Future City Competition 2017 Official Team Optional Tasks Checklist

COMPLETE? TASK DUE DATE

Submit request to substitute alternate to serve in place of one of the official 3 student presenters in event of emergency

February 1

If you are arriving at BWI or IAD airports, arrange Super Shuttle Reservations.

Prior to Arrival

If your team is arriving earlier or staying later than the scheduled Finals dates, make personal reservations at Hilton or alternate hotel.

Prior to Arrival

Notify Linder Global if your team prefers to cover the cost of single room instead of having a student share the room with a student of the same gender from another team.

2 weeks prior to the team’s scheduled arrival in DC

10E D U C A T O R / M E N T O R / O P T I O N A L T A S K S C H E C K L I S T S

Future City Competition 2017 Official Team Friends And Family Checklist

COMPLETE? TASK DUE DATE

Register to attend 2017 Finals:www.regpacks.com/futurecityfamilyandfriends

February 3

Make hotel reservations. Group rate applies until room block is sold out. Reservations for Capital Hilton can be made online via this link: https://resweb.passkey.com/go/FutureCityFebruary2017 or by calling 1-800-HILTONS with the code FCTY.

As soon as possible! group rate is available on a first-come first-served basis and may sell out.

Purchase tickets online for Welcome Party on Saturday, February 18 ($10 per person)

February 3

Make reservations online for the DC Bus Tour on Monday, February 20 (free; reservations required)

February 3

Pick up name badges at the Family & Friends Registration & Welcome Desk

Saturday, Sunday or Monday of Finals

Required Competition Forms 1. You will need to submit the following forms by February 3:

• MedicalRelease

• MediaWaiver

Forms are located on page 12 and 13 or downloadable from: http://futurecity.org/2017-finals-information

2. Email completed forms to: [email protected]

11F R I E N D S A N D F A M I L Y C H E C K L I S T / R E Q U I R E D C O M P E T I T I O N F O R M S

2017 Finals Medical ReleasePlease complete one form for each student team presenter. Completed forms should be returned to [email protected] by February 3.

Student’s Name DOB

Street Address City State ZIP

EMERgENCY CONTACT INFORMATION

Father’s Name Home Ph ( ) Work Ph ( )

Mother’s Name Home Ph ( ) Work Ph ( )

In an emergency when parent/guardian cannot be reached, please contact the following:

Name Home Ph ( ) Work Ph ( )

Name Home Ph ( ) Work Ph ( )

MEDICAL HISTORY

Allergies Other Medical Conditions

Physician Ph ( )

Medical/Hospital Insurance Company Ph ( )

Policy Holder’s Name PolicyNumber

THIS AUTHORIZATION FOR EMERGENCY MEDICAL TREATMENT MUST BE COMPLETED BEFORE STUDENT CAN PARTICIPATE. TREATMENT FOR INJURY WILL BE BASED ON INFORMATION PROVIDED HEREIN. I the undersigned parent/guardian of the above listed minor participant acknowledge and fully understand that each participant will be engaging in activities that could involve risk of injury, which might result not only from their own actions, inactions, or negligence, but the action, inaction, or negligence of others, there may be other unknown risks not reasonably foreseeable at this time assume all the risk and accept personal responsibility for the damages following such injury, hereby release, discharge, covenants to indemnify and not to sue DiscoverE’s Future City® Competition, its affiliated organization, sponsors,employees,associatedpersonnel,officers,directors,allofwhicharehereinafterreferredtoas“releasees”fromanyandallliabilitytoeachoftheundersigned, his/her heirs or next of kin for any and all against any claim by or on behalf of the applicant as a result of the applicant’s participation in the Program and/or being transported to or from the same, which participation, after careful consideration I hereby authorize, and which transportation I hereby authorize. I hereby give my consent to have a doctor of medicine or dentistry or associated personnel to provide the applicant/participant with medical assistance and/or treatment and agree to be financially responsible for the cost of such assistance and/or treatment. I, also agree to save and hold harmless and indemnify each and all parties herein referred to above as releasee from all liability, loss, cost, claim or damages whatsoever which may be imposed upon said releasee because of any defect in or lack of such capacity to so act or caused or alleged to be caused in whole or in part by the negligence of the releasee. I have read the above waiver/release and sign below voluntarily.

Parent/Guardian Signature Date

NOTE: ATTACH COPY OF YOUR INSURANCE CARD, FRONT AND BACK, TO EXPEDITE MEDICAL TREATMENT.

122 0 1 7 F I N A L S M E D I C A L R E L E A S E

Media Waiver

FUTURE CITY TEAM NAME:

ORGANIZATION/SCHOOL:

EDUCATOR:

Student Media WaiverBy signing below, we give our consent to DiscoverE and Future City® and any of its official sponsors or affiliates to use the student’s name, photograph, likeness and program deliverables in order to promote the Future City Competition. We understand that the student may be called upon by journalists to answer questions about his/her involvement in the Future City Competition. The student will be allowed to speak to any media via phone or television.

Date: Future City Region:

Student Name (Please Print):

Guardian Name (One Only):

Guardian Signature:

Guardian’s Email*:

City: State: Zip:

*Your email will be added to our database for future evaluation studies. If you’d like to opt out, please send us an email at [email protected].

Educator/Mentor Media WaiverBy signing below, I give my consent to DiscoverE and Future City® and any of its official sponsors or affiliates to use my name, photograph and likeness in order to promote the Future City Competition. I understand that I may be called upon by journalists to answer questions about my involvement in the Future City Competition, and I will also speak to any media via phone or television.

Date: FC Region:

Name (Please Print):

City: State: Zip:

Signature:

Please complete and return to [email protected] by February 3. A media waiver must be completed by each member of the official team.

13M E D I A W A I V E R