Creating Your World 2024

Monday, June 24, 2024 at 9:00 AM until Friday, June 28, 2024 at 4:00 PMMountain Daylight Time UTC -06:00

CSU Engineering Building
400 Isotope Drive
Fort Collins, CO 80521
United States

New this year for 7th - 9th graders with previous engineering and/or STEM experience. CSU faculty and students will work one-on-one with participants in design activities chosen to simulate real-world, entrepreneurial, engineering problems. Students will be tasked with identifying a problem to solve and then will design, build, test, iterate, and demonstrate a solution (such as an Arduino-controlled robot). Students will also tour and utilize CSU's state-of-the-art 3D printers, mechatronics lab, and machine shop to create their designs.

Program cost is $500. Please send all scholarship inquiries to mechcamp@colostate.edu.

Deposit: http://events.egov.com/eventreg/CO/event.htm?name=mecreatingyourworlddeposit

Full Payment: http://events.egov.com/eventreg/CO/event.htm?name=mecreatingyourworldfullpayment

Participant Information [?]

First Name *

Preferred First Name

Last Name *

Birthdate *

I consider myself Hispanic and/or Latino

Ethnicity (select all that apply)

American Indian or Alaska Native (Original Peoples)

Asian, Japanese, Chinese, Vietnamese, Korean, Filipino (Indian subcontinent)

Black or African American (including Africa and Caribbean)

Native Hawaiian or Other Pacific Islander (Original Peoples)

White, Anglo, Caucasian (including Middle East, Persia)

Gender

Man

Woman

Nonbinary

Add Another Gender

Additional Gender

Pronouns

He/Him

She/Her

They/Them

Add Another Pronoun Set

Additional Pronouns

Contact Information

Email Address *

Mobile Phone

Would you like to receive text updates from CSU?

Yes

Mailing Address

Country

Street

City

Region

Postal Code

School Information

Are you in High School?

Yes

High School Name *

High School Ceeb Code - Hidden Field

If you plan to go to college, when would you be starting? *

Student Type - hidden field default to freshman

Level Code - Default to High School

Parent/Guardian Information

Parent/Guardian *

First Name *

Last Name *

Email *

Phone *

Parent/Guardian

First Name

Last Name

Phone

Event Information

T-Shirt Size

Do you have any dietary restrictions? *

Yes

Do, you, the participant suffer from any allergies? *

Yes

Do, you, the participant have any known reactions to any drugs/medications, insect bites, etc.? *

Yes

Do, you, the participant have any chronic illnesses or injuries we should know about? *

Yes

Will, you, the participant need to take any medications during the Creating Your World 2024? *

Yes

Is there anything else we other conditions we should know about in order to ? *

How did you hear about us?

CSU Mechanical Engineering Newsletter

School Newsletter

Social Media

Word of Mouth

CSU Admissions Website

Other

Other Reason

Have you attended this summer program before?

Yes

Emergency Contacts Information [?]

Relationship to Participant *

First and Last Name *

Phone *

Email *

Relationship to Participant *

First and Last Name *

Phone *

Email *

Primary Physician Information

Name of Physician Clinic

Physician First and Last Name *

Physician Phone *

Insurance Company Information

Do you have health insurance?

Yes

Insurance Company Name *

Policy Holder First and Last Name *

Insurance Company Phone Number *

Group or Policy Number *

Member ID Number *

Waivers and Release Forms

Media Communication and Photo Release

Media Communication and Photo Release
To participate in the Colorado State University Program, I, give my permission for and grant CSU the irrevocable right to:

Record my child’s participation in the program and appearance on video, audio, film, photograph or any other media, whether now known or hereafter existing (the “Recordings”). Use my child’s name, likeness, and/or voice in connection with the Recordings and in keeping with CSU policies and mission statement.
Use, reproduce, distribute, publicly display and/or publicly perform the Recordings, either electronically or by any other media, whether now known or hereafter existing, and to allow others to do the same, my child’s name, likeness or voice, in whole or in part worldwide, without restrictions or limitations, in perpetuity, for any purpose related to CSU’s mission, including without limitation, promotional or educational.
I agree to release CSU and its Board of Governors, officers, employees, students, volunteers, and agents from any liability to me or my child, and on behalf of my heirs, executors, administrators, legal representatives and assigns, based upon or arising out of use of my child’s name, likeness or voice, or the Recordings.
I agree to make no monetary or other claim against CSU for use of my child’s name, likeness or voice, or the Recordings.

This release shall be governed in accordance with the laws of the State of Colorado.

Media Communication and Photo Release

Media Communication and Photo Release
To participate in the Colorado State University Program, I, give my permission for and grant CSU the irrevocable right to:

Record my child’s participation in the program and appearance on video, audio, film, photograph or any other media, whether now known or hereafter existing (the “Recordings”). Use my child’s name, likeness, and/or voice in connection with the Recordings and in keeping with CSU policies and mission statement.
Use, reproduce, distribute, publicly display and/or publicly perform the Recordings, either electronically or by any other media, whether now known or hereafter existing, and to allow others to do the same, my child’s name, likeness or voice, in whole or in part worldwide, without restrictions or limitations, in perpetuity, for any purpose related to CSU’s mission, including without limitation, promotional or educational.
I agree to release CSU and its Board of Governors, officers, employees, students, volunteers, and agents from any liability to me or my child, and on behalf of my heirs, executors, administrators, legal representatives and assigns, based upon or arising out of use of my child’s name, likeness or voice, or the Recordings.
I agree to make no monetary or other claim against CSU for use of my child’s name, likeness or voice, or the Recordings.

This release shall be governed in accordance with the laws of the State of Colorado.

I, the participant, have read and agree to the Media Communication and Photo Release

I, the parent/guardian, have read and agree to the Media Communication and Photo Release

CSU Recreation Center Liability Waiver and Medical Release

CSU Recreation Center Liability Waiver and Medical Release
In consideration of the Board of Governors of the Colorado State University System, acting by and through Colorado State University, its directors, officers, agents, employees, volunteers, representatives and any other persons or entities acting on their behalf (“Colorado State University”) allowing me to participate in the Colorado State University Campus Recreation programs, and all related events and activities (the “Program”), I do voluntarily and willingly acknowledge and enter into the following agreement (“Release”).

I am exercising my own free choice to participate voluntarily in the Program and I promise to take due care during such participation. I hereby release, discharge, waive, indemnify and hold harmless Colorado State University, and any successors and assigns, for any and all claims and demands of any kind that arise from or relate to my participation in the Program. I acknowledge and understand that this Release releases and discharges Colorado State University from any and all liability and claims, including but not limited to any liability or claim by me or anyone else with respect to any bodily injury, personal injury, illness, death, property damage, or economic damage of any kind that may result from my participation, whether caused by me, a third party, the negligence of Colorado State University, or otherwise.

In choosing to participate in the Program, I understand that I will have the opportunity to engage in many activities, potentially including but not limited to use of, or participation in, the following: Rec Center facilities and equipment; Climbing Wall; Aquatics; Weight Lifting and Weight Training; Cardio; Intramural and Club Sports, such as basketball, soccer, volleyball, football, and softball; Racquet Sports, such as tennis and racquetball; Running; Stretching; Group Activity and Fitness Classes, such as kickboxing, Zumba, step, yoga, cardio, spin/cycling and martial arts; Fitness and Exercise Programs, including training, instruction, and Personal Training; and Outdoor Programs, such as rock climbing, hiking, backpacking, biking, mountain biking, fishing, kayaking, wilderness adventure, team building, and winter sports (skiing, skating and snowboarding). I further understand that I am free to choose those activities that I most enjoy and that my physician and I deem are safe for my participation. I understand that there are some discomforts and risks associated with physical activity, such as muscle soreness, strains, and sprains, as well as cardiovascular problems including abnormalities of blood pressure or heart rate, ineffective heart function, and, possibly heart attack or cardiac arrest and death. I understand that I should report promptly to my physician any signs or symptoms indicating any injury, abnormality or distress.

I acknowledge and understand that there are known and unknown hazards involved in my participation in the Program, including, but not limited to, pulled/strained muscles, dislocations, amputations, injuries or damages to head, teeth, joints and ligaments, cuts and bruises, concussions, sprains, broken bones, paralysis, exposure to outdoor elements, damage that can result from increased heart rate including heart attack or stroke, drowning, and death, as well as property or other damage. I also understand that the hazards described herein are only a partial list of the risks and hazards and that other hazards may be involved that have not been identified in this document or otherwise disclosed, and I fully assume those hazards as well. By signing this Release and choosing to participate in the Program, I expressly and knowingly assume the risks of the hazards described herein, and any other known or unknown hazards involved in participating in the Program, and waive all claims against Colorado State University. I understand that I am solely responsible for any costs arising out of any bodily injury or property damage sustained through my participation in normal or unusual acts associated with the
Program.

I declare that I am currently in good health and have not been diagnosed with a medical condition and/or heart condition that would disqualify me from participating in the Program. I understand that medical services or facilities may not be readily available during the Program. In the event of an emergency, I hereby authorize, consent and give my permission to Colorado State University to obtain medical treatment for me at the nearest hospital, medical facility, or doctor, at my sole expense. I further authorize appropriate Colorado State University personnel to treat any injury or illness as they think best for my welfare, if necessary.

If I use my private motor vehicle to transport myself, fellow students, and/or any other persons to and from any Program, I hereby agree to have insurance coverage for my vehicle and any passengers as required by law, and I hereby certify that I presently have a policy of vehicle insurance providing at least, and as a minimum, coverage levels required by applicable law.
I understand that this Release shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law, and that if any portion of this Release is declared invalid, for whatever reason, the remaining portions shall continue to be valid and legally binding. I affirm that we have read the terms and provisions of the Release prior to its execution and that I have had the opportunity to consult with whomever I wish, including an attorney, and that Colorado State University has made no representation, statement or inducement, directly or indirectly, on which I rely, and that this Release contains the entire agreement between Colorado State University and me. I agree that this Release shall be governed by the laws of the State of Colorado, without regard to any conflict of law provisions. I fully understand and acknowledge that Colorado State University has never expressly or impliedly assumed any responsibility for my participation in the Program. On my own free will, I hereby personally assume all risks in connection with participation in the Program or any other activity connected therewith. This Release shall be binding upon me, my spouse, my children, my heirs, administrators, personal representatives and assigns, forever.

CSU Recreation Center Liability Waiver and Medical Release

I, the participant, have read and agree to the CSU Recreation Center Liability Waiver and Medical Release

I, the parent/guardian, have read and agree to the CSU Recreation Center Liability Waiver and Medical Release

Student Participation Contract

Participation Contract

Student Participation Contract
A high degree of responsibility and maturity is expected of our participants. It is important for reasons of safety and program effectiveness that certain standards of behavior be followed by all students. Your signature on this form indicates that you have read, understand, and agree to follow the rules listed below. Violation of any of the rules may be cause for expulsion from the program or for other appropriate disciplinary action to be determined by staff.

All participants must attend all sessions and activities. Absence or tardiness is unacceptable except for excused medical emergencies. Note: Excused absence must be arranged on an individual basis, and must be specifically authorized by the Program Coordinators.
The use or possession of drugs, alcohol or weapons during the Summer Institute is not permitted under any circumstances, and is cause for immediate expulsion. This includes being in the company of another person who is using or is in possession of drugs, alcohol, or weapons. CSU Police department will be contacted to handle any such occurrences.
Curfew in the Residence Hall begins at 9 pm on-the floor for all residents and in individual rooms at 10 pm. Quiet hours are 10 pm to 7 am.
No participant may ride in or drive any personal vehicle during the program unless arrangements are made in advance with the Program Coordinators.
Participants are not allowed to leave the CSU Main campus at any time unless accompanied by a staff member or parent/guardian with prior approval.
Participants are expected to behave in a respectful, responsible, and non-disruptive fashion at all times and are expected to exercise sound judgment regarding behavior. Any questions about particular situations should be addressed with Program Coordinators, Instructors, or Mentors.
Participants are not to engage in any verbal, physical or sexual harassment of others and will be cause for immediate expulsion. This includes harassing or intimidating others via text, email, newsgroups or web pages while using CSU’s Computing and Network Resources.
Participants and parents are responsible for reading, understanding, and following these policies.
Throughout the camp, participants will be using tools and equipment that are inherently dangerous. Participants are expected to use caution and follow all safety protocols and instructions at all times.
Participants must follow all rules and terms of dormitories and student recreation center, including:
- I understand that I am liable as an individual or as part of the Summer Camp group for any damage that I, or we, as a group may cause in and around the residence hall, classroom or visited facility and agree to pay for the replacement or restoration of the property.
- I understand that I am responsible for my room key and, if lost, I will be charged $65.00 for the replacement of the lock and key.
- I understand that UNDER NO CIRCUMSTANCES may any screen be removed from any window. If a screen is tampered with, damaged, or removed, I will be charged $50.00.
- All participants will have access to CSU’s computer networks. In consideration of being allowed to use the University's central computer and network services, participants agree to refrain from any illegal activity or for any activity prohibited by CSU’s Acceptable Use Policy for Computing and Networking Resources. If you have questions regarding illegal activity, inappropriate or destructive actions pertaining to computing resources, you may view CSU’s complete Acceptable Use Policy.
- Violation of the camp rules will result in incident-appropriate disciplinary action as determined by camp staff and camp directors. Campers may be removed from individual activities, removed from dormitories, or expelled from camp at the expense of the parents.

Student Participation Contract

Participation Contract

All participants must attend all sessions and activities. Absence or tardiness is unacceptable except for excused medical emergencies. Note: Excused absence must be arranged on an individual basis, and must be specifically authorized by the Program Coordinators.
The use or possession of drugs, alcohol or weapons during the Summer Institute is not permitted under any circumstances, and is cause for immediate expulsion. This includes being in the company of another person who is using or is in possession of drugs, alcohol, or weapons. CSU Police department will be contacted to handle any such occurrences.
Curfew in the Residence Hall begins at 9 pm on-the floor for all residents and in individual rooms at 10 pm. Quiet hours are 10 pm to 7 am.
No participant may ride in or drive any personal vehicle during the program unless arrangements are made in advance with the Program Coordinators.
Participants are not allowed to leave the CSU Main campus at any time unless accompanied by a staff member or parent/guardian with prior approval.
Participants are expected to behave in a respectful, responsible, and non-disruptive fashion at all times and are expected to exercise sound judgment regarding behavior. Any questions about particular situations should be addressed with Program Coordinators, Instructors, or Mentors.
Participants are not to engage in any verbal, physical or sexual harassment of others and will be cause for immediate expulsion. This includes harassing or intimidating others via text, email, newsgroups or web pages while using CSU’s Computing and Network Resources.
Participants and parents are responsible for reading, understanding, and following these policies.
Throughout the camp, participants will be using tools and equipment that are inherently dangerous. Participants are expected to use caution and follow all safety protocols and instructions at all times.
Participants must follow all rules and terms of dormitories and student recreation center, including:
- I understand that I am liable as an individual or as part of the Summer Camp group for any damage that I, or we, as a group may cause in and around the residence hall, classroom or visited facility and agree to pay for the replacement or restoration of the property.
- I understand that I am responsible for my room key and, if lost, I will be charged $65.00 for the replacement of the lock and key.
- I understand that UNDER NO CIRCUMSTANCES may any screen be removed from any window. If a screen is tampered with, damaged, or removed, I will be charged $50.00.
- All participants will have access to CSU’s computer networks. In consideration of being allowed to use the University's central computer and network services, participants agree to refrain from any illegal activity or for any activity prohibited by CSU’s Acceptable Use Policy for Computing and Networking Resources. If you have questions regarding illegal activity, inappropriate or destructive actions pertaining to computing resources, you may view CSU’s complete Acceptable Use Policy.
- Violation of the camp rules will result in incident-appropriate disciplinary action as determined by camp staff and camp directors. Campers may be removed from individual activities, removed from dormitories, or expelled from camp at the expense of the parents.

I, the participant, have read and agree to the CSU Student Participation Contract

I, the parent/guardian, have read and agree to the CSU Student Participation Contract

Medical Waiver

Medical Waiver
In the event of an accident or illness, which may require medical attention while attending activities at Colorado State University, I give permission for my child to be treated at Hartshorn Health Service, Poudre Valley Hospital, or by any available physician, emergency medical technician or dentist. I grant permission to the treating physician or other health care providers to employ such diagnostic procedures and medical treatment as deemed necessary. I authorize all medical care units to release medical record information to the University's worker's compensation health care provider and insurance carrier in order to process claims. I understand that I am financially responsible for all charges and hereby guarantee full payment to the physicians or health care units. Without my express revocation, this consent for treatment is good for ninety (90) days from the date of signing. I do hereby indemnify and hold harmless the physician, hospital, the University, and other persons who act in reliance upon this authorization.

Medical Waiver

I, the parent/guardian, have read and agree to the terms and conditions in the Medical Agreement

Cell Phone Agreement

Cell Phone Agreement
Each day, participants will be expected to leave their cell phone in their room during institute programming. Parents/guardians will be out of communication with their child during that time. Participants will be supervised by CSU staff and mentors at all times. In the event of an emergency, parents/guardians will be contacted immediately. Should there be a situation where a parent/guardian needs to contact their child, Program Coordinators will be available to receive calls and connect participants.

Cell Phone Agreement

I, the participant, have read and agree to the terms and conditions in the Cell Phone Agreement

Participant Agreement

Parent/Guardian Agreement

Test Record (Hidden)

Yes