Hands on Healthcare at RockhurstThursday, June 4, 2026 at 8:00 AM until Friday, June 5, 2026 at 4:30 PMCentral Daylight Time UTC -05:00Map and DirectionsSedgwick Hall5225 Troost AveKansas City, MO 64110United StatesExplore healthcare careers through interactive workshops, clinical simulations, and mentorship from professionals. Designed for high school students interested in science and making a difference.Camp Information: Thursday, June 4, 8:00 am - 4:30 pm Friday, June 5, 8:00 am- 4:30 pm Lunch is included both days Loading...Participant Contact InformationFirst NamePreferred NameLast NameBirthdateBirthdateJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember123456789101112131415161718192021222324252627282930312026202520242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900Mailing AddressMailing AddressCountryStreetCityRegionPostal CodeEmail AddressMobile Phone NumberI give permission to Rockhurst University to send me important updates via text messaging. (Standard message charges apply.)I give permission to Rockhurst University to send me important updates via text messaging. (Standard message charges apply.)YesNoParent/Guardian Contact InformationThe information provided here will serve as the emergency contact information for the participant.Parent/Guardian First NameParent/Guardian Last NameParent/Guardian Email AddressParent/Guardian Mobile PhoneEvent InformationWhich high school do you attend?CEEB CodeWhen will you graduate high school?May/June 2026May/June 2027May/June 2028May/June 2029May/June 2030Prospect Type (hidden)Prospect Type (hidden)FreshmanSelect your t-shirt size. Extra SmallSmallMediumLargeExtra Large2XL3XLDo you require any reasonable accommodations to fully participate in this event due to a disability? If so, please specify your needs.Do you have any food allergies or dietary restrictions? If so, please list them below. Minors Assumption of Risk, Release & Waiver of Liability AgreementAll students who will be under 18 at the time of the event must review our assumption of risk, release, and waiver of liability agreement. This must be signed by both the student and parent/guardian. In consideration of the services provided by Rockhurst University, its board, employees, volunteers, participants, and all other persons or entities acting in any capacity on its behalf (collectively referred to as “UNIVERSITY”) in conjunction with the Hands on Health Summer Camp (“Event”), I hereby agree to release, hold harmless, and discharge UNIVERSITY, on behalf of myself, my children, my parents, my heirs, assigns, personal representatives and estate as follows: 1. I acknowledge that my participation in the Event entails known and unanticipated risks, which could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I understand that such risks simply cannot be eliminated. I further certify that I am willing to assume the risk of any medical or physical condition I may have. 2. I expressly agree and promise to accept and assume all of the risks existing in this Event. My participation in this Event is purely voluntary, and I elect to participate despite the risks. I hereby give my consent for any medical treatment that may be required, as determined by a medical professional at the medical facility, during my participation in the Event, with the understanding that the cost of any such treatment will be solely my responsibility.3. I hereby voluntarily release, waive, and forever discharge any and all claims of negligence against UNIVERSITY that relate in any way to any activity I undertake in conjunction with the Event, including transportation to and from the Event. 4. Should UNIVERSITY or anyone acting on its behalf, be required to incur attorney’s fees and costs to enforce this Agreement, I agree to indemnify, defend, and hold them harmless for all such fees and costs. 5. I understand that UNIVERSITY may not maintain an insurance policy that would provide coverage in the event that I am injured during the Event or cause any injury during the Event. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating in the Event, or else I agree to bear the costs of such injury or damage myself. 6. I understand that UNIVERSITY may photograph, film, and/or record (“Medium”) my participation in the Event. I authorize UNIVERSITY to use Medium and my likeness in conjunction with any UNIVERSITY marketing and/or promotional materials, including, but not limited to, social media accounts. I understand that I will not be compensated in any way for such use. In the event that I file a lawsuit against UNIVERSITY, I agree to do so solely in the State of Missouri, and I further agree that the substantive law of Missouri shall apply without regard to conflict of law rules. I agree that if any portion of this Agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect. By signing this document, I expressly state that I have had sufficient opportunity to read this entire Agreement. I further certify that I have read and understood it, and I agree to be bound by its terms.I further acknowledge that this document contains a negligence waiver and indemnification provisions. Student Signature I agree and understand that by signing the Electronic Signature Acknowledgment and Consent Form, that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement.Click to Sign...Parent/Guardian Signature In consideration of my child(“Minor”) being permitted to participate in the Event, I agree that my child’s participation in the Event is to be bound by the terms of this Agreement and further agree to waive any and all claims of negligence against UNIVERSITY which are brought by, or on behalf of Minor, and which are in any way connected with the Event, including transportation to and from the Event.I agree and understand that by signing the Electronic Signature Acknowledgment and Consent Form, that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement.Click to Sign...Minors Media, Photo & Video Release FormAll students who will be under 18 at the time of the event must review our media, photo & release form. This must be signed by both the student and parent. PLEASE READ THIS DOCUMENT CAREFULLY BEFORE SIGNING. THIS IS A LEGALLY BINDING DOCUMENT. In consideration for my child’s participation in the above captioned event, I, the undersigned parents/guardians of the minor child indicated below, hereby grant to Rockhurst University, its Board of Trustees, Administration, Faculty, Staff, and all other officers, directors, employees and agents (“the University”) the right to reproduce, use, exhibit, display, broadcast, distribute, modify, adapt, and create derivative works of photographs, videotaped images or video/audio recordings of my child (“Materials”) by incorporating them into publications, catalogues, brochures, books, magazines, photo exhibits, motion picture films, videos, electronic media, web sites, and/or other media, or commercial, informational, educational, advertising, or promotional materials or publications related thereto (“Works”). It is agreed that the Works will be used in connection with University business, the activities of the University, or for promoting, publicizing or explaining University activities or events. Materials may appear in any of the wide variety of formats and media now available to the University and that may be available in the future, including but not limited to print, broadcast, videotape, CD-ROM and electronic/online media. I waive my right to inspect or approve any Works that may be created by the University using the Materials and waive any claim with respect to the eventual use to which Materials may be applied. I understand and agree that the University is and shall be the exclusive owner of all right, title, and interest, including copyright, in the Works, and any commercial, informational, educational, advertising, or promotional materials containing the Materials. All electronic or non-electronic negatives, positives, and prints are owned by the University. I also understand that neither I nor my child will receive compensation in connection with the use of my child's image. I understand that the terms of this RELEASE are contractual and not a mere recital. The information I have provided is disclosed accurately and truthfully. I acknowledge that I am signing this document freely and voluntarily. My signature on this document is intended to bind not only myself but also my successors, heirs, representatives, administrators, and assigns. Student SignatureI agree and understand that by signing the Electronic Signature Acknowledgment and Consent Form, that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement.Click to Sign...Parent/Guardian SignatureI agree and understand that by signing the Electronic Signature Acknowledgment and Consent Form, that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement.Click to Sign...Hands on Heathcare Summer Camp PaymentAmount DueLoading...Submit