Agreement Form for Natural History of Hawaii
To be printed and filled out:
Personal Information
Name:
First Last Middle
Date of Birth:
Month Day Year
Mailing Address
Street:
City,State,Zip:
Contact Information
E-Mail:
Work Phone:
Home Phone:
Academic Information
College where you will be registering for this program
PhoenixCollege(PC):
ScottsdaleCommunity College (SCC):
Responsibilities of the Participants
You will be expected to do all of the following actions.
Check any action that you have questions about or anticipate problems completing:
  1. Enroll and pay the MCCD tuition and registration fees prior to departure.

  1. Pay MCCD Program Fee prior to departure.

  1. Attend orientation sessions at PC prior to departure.

  1. Purchase supplies prior to departure.

  1. Pay Kohala Center Program Fee prior to departure.

  1. Arrange and pay for air travel prior to departure.

  1. Pack appropriately prior to departure.

  1. Endure the airplane journey and the consequent “jet lag”.

  1. Get to the HPA Dormitory to meet the MCCD Faculty on July 5, 2007.

  1. Pay rental fees for snorkeling gear.

  1. Walk to nearby shops and pay for personal supplies while in Hawaii.

  1. Walk to classroom from accommodations.

  1. Be in good physical condition to easily accommodate daily outdoor hiking, swimming, and snorkeling.

  1. Be able to accommodate to varying sea conditions.

  1. Be an active participant in class activities. Be self-motivated and disciplined to follow required daily schedule of instruction, group projects and field trips.

  1. Be willing, able and dependable in your interactions with other class participants. Act as a team player. Be responsible for maintaining your part in the group association.

  1. Be willing, able and dependable as a snorkeling buddy. Snorkeling is an interdependent activity.

  1. Be open, honest and realistic with yourself and others about your snorkeling experience, skill levels, and comfort zone in the water.

  1. Be willing and able to respond to the advice of the group leaders and other professionals. Be willing to accept decisions made to protect your safety and your well being.

  1. Be flexible. Understand that our itinerary can be disrupted due to any number of unforeseeable events such as weather, mechanical/technological difficulties, ill health, etc.

  1. Be self sufficient in spending any unsupervised free time in a responsible manner.

  1. Be respectful of Hawaiian culture and abide by all laws.

  1. Be open and enthusiastic to meeting new people of various cultural and ethnic backgrounds.

  1. Get home from Captain Cook, HI on or after July 19.

Agreement/Applicant’s Signature
I agree to notify the program instructor of any problems I might have with meeting the above responsibilities. I understand that my application will be reviewed and can be accepted or denied. I certify that all information on this agreement form is correct. I hereby certify that I will be able to meet the above listed responsibilities that I have not checked.
Signature of Applicant:
Date: