OFFICE
Invent Now, Inc.
3701 Highland Park NW
North Canton, OH 44720
DEAR PARENT /GUARDIAN,
PHONE
800.968.4332
Enclosed you will find important paperwork including:
EMAIL
[email protected]
WEB
inventionproject.org
Thank you for choosing Invention Project (IP) and investing in your Innovator’s
future! We can’t wait to meet your son or daughter in just a few weeks. We hope
their Invention Project experience will be their favorite part of summer!
yy Program Information
yy Acceptable upcycle materials list
yy Participant Information Form
Please fill out these forms and bring them with you on the first day of
Invention Project. You must have these completed in order to participate.
Note that these forms require the signature of both parents or legal guardians.
If you have any questions or concerns, please do not hesitate to call us at
800.968.4332 or email us at [email protected]
–The Invention Project Team
“As prototypes unfold, they allow you to work on things, they allow you to make changes—prototypes don’t often work,
they break, they change, you have new ideas. You have to manipulate them a lot. Your prototype has to be flexible.”
- Steve Sasson, Inventor of the Digital Camera and 2011 National Inventors Hall of Fame Inductee.
© 2015 Invent Now, Inc. All Rights Reserved
WHAT YOU CAN DO TO IMMEDIATELY HELP PREPARE YOUR INNOVATOR FOR INVENTION PROJECT
yy If your son or daughter has any special needs, such as diabetes or severe allergies that warrant the administration of epinephrine,
please call 800.968.4332 as soon as possible to make any necessary arrangements;
yy Start collecting materials to upcycle that will be shared by all. See the guidelines on the next page.
WHAT TO BRING TO INVENTION PROJECT
yy A packed lunch clearly labeled with your son or daughter’s name every day;
yy A completed Participant Information Form;
yy Materials to upcycle and share throughout the week of Invention Project. The more you bring, the better experience for
your Innovator.
WHAT YOU CAN DO TO FACILITATE AN EASIER CHECK-IN ON THE FIRST DAY
yy Please plan to arrive 30 minutes early on the first day of the program, with materials to upcycle and the completed
Participant Information Form;
yy Your son or daughter should be dressed in comfortable clothes and shoes – no flip-flops please;
yy Unless you authorize your son or daughter to sign him/herself in and out daily during the duration of the program, you or an
authorized individual are required to do so.
ADDITIONAL INFORMATION
Your Innovator’s Invention Project experience is just as important to us as it is to you. We will distribute a newsletter on the first and
the last day of the program, allowing you to fully understand how we view the prototyping process and learn a little more about the
program’s highlights.
The newsletter is also meant to encourage conversations with your son or daughter about his or her experience, so we share ideas
that will motivate your family to keep up the spirit of Invention Project at home.
When talking to your son or daughter, or when looking at his or her prototypes, please remember that prototypes may not be
functional, but like all prototypes they’ll represent a bigger idea. In order to allow all participants to create their best possible
invention, we encourage teams to learn from mistakes, brainstorm and work together.
© 2015 Invent Now, Inc. All Rights Reserved
IDENTIFYING AND COLLECTING ITEMS TO UPCYCLE
Help our program participants with their prototypes by collecting upcyclable materials to use and share. These items are an
important component to the design process. Please refer to the listed items when determining whether an item is acceptable
or unacceptable.
IMPORTANT: Please thoroughly wash out all bottles, containers, foam trays and any other items as needed.
ACCEPTABLE ITEMS FOR UPCYCLING
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Beads, buttons and craft supplies
Boxes (shoe, cereal, etc.)
Bubble wrap
Building blocks
CDs
Containers/lids
Fabric
Film canisters
Foam trays
Game parts
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Miscellaneous paper (magazines, newspaper, kraft etc.)
Milk /OJ cartons /jugs (rinsed)
Oatmeal canisters
Paper towel tubes
Pinwheels
Plastic bottle caps
Pulleys
Rubber bands
Springs
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Packing peanuts
Paint
Prescription bottles
Soda pop cans
Wire hanger
UNACCEPTABLE ITEMS FOR UPCYCLING
yy Batteries
yy Cords
yy Glass
yy Glitter
yy Liquids
yy Medicine containers
ACCEPTABLE BEHAVIOR POLICY
It is important to Invention Project that all participants receive a positive and rewarding experience while attending our program.
In order to ensure a safe and fun environment for all, participants are expected to behave in an acceptable manner and use
appropriate language. ANY behavior deemed to be detrimental to or in violation of Invention Project standards will be dealt with
by the staff and/or Director. Unacceptable behavioral instances include, but are not limited to: any form of intended harm
to another participant or staff member, bullying or any form of aggression.
Any situation that involves distracting other participants or disrupting Invention Project activities will not be tolerated. It is important to
remember that there are NO REFUNDS if a participant is asked to leave Invention Project due to unacceptable behavior. By paying
your registration fee in full, you signify that you understand and agree to the Acceptable Behavior Policy.
I have read and will abide by the Invention Project rules. I understand that Invention Project staff have the right to remove any person
from the program that does not abide by these rules. If I am asked to leave, I understand that my tuition is nonrefundable.
Parent/Guardian Signature
Parent/Guardian Signature
Participant’s Signature
© 2015 Invent Now, Inc. All Rights Reserved
PARTICIPANT INFORMATION FORM
PARTICIPANT INFORMATION
LIABILITY WAIVER
MUST be signed in order for your son or daughter to participate.
Paticipant’s Name
Invention Project is a safe environment. You can have full confidence
that precautions will be taken to ensure the safety of your son or
daughter and that your son or daughter will be supervised by adults
during the week of your program. However, you must sign this waiver
in its original form, without alterations, for your son or daughter
to participate.
Date of Birth
Program Location
Parent/Guardian Name
I am the parent/legal guardian of (“participant”). On my own behalf and as parent and guardian,
I acknowledge and agree that there is the possibility of physical injury
or loss associated with my son or daughter’s participation in the
Invention Project program (the “Invention Project Program”). I hereby
release, discharge Invention Project, its affiliated organizations,
employees and associated personnel including the owners of the
Program facility against any and all claims, liabilities and/or damages
as a result of my son or daughter’s participation in the program,
including but not limited to, any claim that Invention Project was
negligent. I further agree to defend and indemnify Invention Project,
its affiliated organizations and employees and associated personnel
if any claim is made against them by or on behalf of my son or
daughter. I understand that my son or daughter will not be permitted
to participate in the Program without my signing this Agreement.
Finally, I acknowledge that Invention Project is an Ohio organization
and I agree that Ohio law will govern the interpretation and validity
of this liability waiver.
Street Address
Parent/Guardian Signature
Date
CityState
Parent/Guardian Signature
Date
Zip Code
ALTERNATIVE CONTACTS/
TRANSPORTATION ARRANGEMENTS
Primary Parent /Guardian Home Phone Number
In the event of an emergency, I authorize the following individual(s)
to pick up my son or daughter from the program
CityState
Zip Code
Grade Level Next Fall
PARENTS/GUARDIAN INFORMATION
Parent/Guardian Name
Primary Parent /Guardian Work Phone Number
Primary Parent /Guardian Cell Phone Number
Name/Relationship
Phone Number
Name/Relationship
Phone Number
My son or daughter may:
PHOTOGRAPHY RELEASE
Sign him/herself in and out Walk and/or Ride his/her bicycle home
I authorize the Invention Project program to obtain, store and/or use
(without payment) any photographs, slides and/or videotapes of my
son or daughter for public relations, marketing/advertising and/or
internal training purposes.
Parent/Guardian Signature
Date
Parent/Guardian Signature
Date
Parent/Guardian Signature
Date
Parent/Guardian Signature
Date
© 2015 Invent Now, Inc. All Rights Reserved
EMERGENCY MEDICAL CONSENT
In the event that reasonable attempts to contact me and the two
alternate individuals that I have designated at the phone numbers
that I have provided on this form have been unsuccessful, I hereby
give my consent for the administration of any treatment deemed
necessary by the physician, dentist and/ or hospital, as applicable,
listed below:
Preferred Physician
Preferred Dentist
Preferred Hospital
List any special needs, important medical history/behavior and/or
accommodations that can be made to make your son or daughter’s
experience more successful:
y son or daughter is carrying an inhaler and is authorized to
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self-administer as needed. (Physician’s order has been completed
at the bottom of this form).
Phone Number
Phone Number
Phone Number
In the event that the designated preferred physician, dentist and/or
hospital, as applicable, is not available, I hereby give my consent for
the administration of any treatment deemed necessary by another
licensed physician or dentist at any hospital reasonably accessible.
This authorization does not cover major surgery unless the medical
opinions of two other licensed physicians or dentists (as applicable),
concurring in the necessity for such surgery, are obtained before
surgery is performed.
Parent/Guardian Signature
Date
Parent/Guardian Signature
Date
EMERGENCY MEDICAL REFUSAL
I do not give my consent for emergency medical treatment of my
son or daughter. In the event of illness or injury requiring emergency
treatment, I wish the school authorities to take no action or to:
y son or daughter is attending with an epinephrine injection to be
M
administered in the event of a severe allergic reaction.
IMPORTANT: Epinephrine administration forms must be completed by
parents and the physician. The Director must be trained by the parent in the
administration of the epinephrine injection prior to the start of the program.
Parents of participants with such severe allergies and other special needs
must call 800.968.4332 to acquire these forms and begin making the
necessary arrangements.
PHYSICIAN’S ORDER FOR PRESCRIBED
ORAL MEDICATION
All medication must be delivered in the original container in which
it was dispensed and administered by a pre-authorized individual
designated by the parent/guardian. No member of the Invention
Project program is permitted to administer medication.
I have arranged, and hereby authorize, the administration of prescribed
medication for my son or daughter to be handled as follows:
Name of Medication
Do not sign if Emergency Medical Consent was authorized above.
Dosage
Name of Authorized Individual
to Administer Medication
Date(s) and Time(s)
of Administration by
aforementioned individual
Name of Issuing Physician
Issuing Physician Emergency
Phone Number
Significant side effects (adverse reactions) that should be reported
to the physician:
Parent/Guardian Signature
Date
Parent/Guardian Signature
Date
PARTICIPANT MEDICAL INFORMATION
Allergies (food, medication, etc.): Activity restrictions or precautions: List any medication participant is currently taking: Issuing Physician Signature
Date
Parent/Guardian Signature
Date
Parent/Guardian Signature
Date
© 2015 Invent Now, Inc. All Rights Reserved