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2012 AJAS Conference (Chaperone/Other)

AJAS Chaperones are science academy representatives, teachers, parents, and/or NAAS board members.


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Privacy Statement

The American Junior Academy of Sciences

The American Junior Academy of Sciences (AJAS) recognizes that individuals with whom we conduct business, including members and program participants, value their privacy. However, in order to conduct business in this increasingly electronic economy, the collection of personal information is often necessary and desirable. It is the goal of AJAS to balance the benefits of e-commerce and direct mail with the right of individuals to prevent the misuse of their personal information.

The collection of personal information

AJAS may request basic, personal information from you, like your name, email address, and name of your employer, telephone, fax and biographical information. AJAS uses this information to communicate with you primarily by mail, phone, fax or email. In some cases we use this information for other purposes such as, but not limited to, the recruitment of volunteers for special tasks or assignments and solicitation of support. In addition, AJAS may use this information for other purposes, such as alerting you to products and services from AJAS or from others who can assist you in your education, profession or enjoyment of science.

In general, you can visit our website without divulging any personal information. However, there are areas of this site that may require this information to complete their customization functions, and may not be available to those choosing not to reveal the information requested.

Although not of a personal nature, AJAS may collect domain information as part of its analysis of the use of our website. In general this data enables us to become more familiar with the several categories or domains of members and customers visiting our site, how often they visit, or what pages of the site they visit most often. AJAS uses this information to improve its Web-based offerings. This information is collected automatically and requires no action on your part.

Disclosure to third parties

In cases where we believe your educational or professional business interests will be served, AJAS may share your information (with the exception of financial information, credit card, and ordering information) with others who can alert you about new products, services, educational or professional opportunities that may be of benefit to you. Most third parties are authorized to use this information on a one-time basis only. However, if you receive unwanted marketing materials from any of our business associates, please let us and them know that you wish to be removed from their contact list. You always have the right to inform us that you do not want us to share this information beyond AJAS.

The American Junior Academy of Sciences reserves the right to change, modify, or update this statement at any time without notice.

Copyright (c) The American Junior Academy of Sciences. All rights reserved. Approved by the NAAS Board; Seattle; February 2004.


First Name (*)

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Middle Initial

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Last Name (*)

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Gender (*)

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Address (*)

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Address (cont.)

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City (*)

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State (*)

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Zip (*)

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Phone Number (Home or Business) (*)

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Cell Phone

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E-Mail Address (*)

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T-Shirt Size (*)

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Are You a US Citizen? (*)

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Citizenship (If Not US)

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Special Diet

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Special Needs (excluding Diet)

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Years Attended (*)

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Academy (*)

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All students must have a chaperone.

List all students that you will chaperone below. If none, enter reason.

Reminder: All adults will serve as a chaperone in some capacity.

Students Chaperoning (*)

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Consent and Release Agreement
Required for participation in the annual meeting of the American Junior Academy of Sciences (AJAS) in association with the National Association of the Academy of Science (NAAS) and the American Association for the Advancement of Sciences (AAAS)

In consideration of the right and opportunity of the undersigned to attend and participate the Annual Meeting or any other activity, program or event of the American Junior Academy of Sciences, the undersigned for him/herself and for his/her heirs and legal representatives hereby:

  1. Fully and forever releases The American Junior Academy of Sciences (herein referred to as the Academy or AJAS), and all of its past, present, and future affiliates, officers, directors, trustees, judges, peer-reviewers, committee members, employees, attorneys, agents, successors and assigns, and each of them, from any and all claims, damages, and causes of action of whatsoever kind or nature resulting from or relating to the undersigned's involvement, participation in or attendance at the activity, program or event;
  2. I realize that emergency medical treatment in the event of illness, injury, accident or incapacity is at my own expense including any and all transportation back to facilities nearer to my hometown in certain medical conditions;
  3. Agrees to indemnify the Academy against, and to save it harmless from, any and all damages, actions, causes of action, claims, judgments, executions, debts, costs of litigation and attorney fees which may in any way arise out of, or result from, the use by the undersigned of the property and facilities owned, used, or rented by the Academy;
  4. Grants to the Academy, and its successors, assigns, agents, grantees, and licensees, the right to take and reproduce writings, photographs, films, and voice recordings of the Undersigned while the undersigned participates in the program, and to use the same and the undersigned's name and any past, current, or future biographical information submitted to the Academy for any and all purposes and in any manner, including commercial publications and advertisements of all kinds in all media;
  5. Agrees to abide by AJAS code of conduct which states that I shall conduct myself in a professional manner at all times abiding by conduct expected of educational institutions. I realize that I am financially responsible for any and all damages to hotel room and for the incurrence of incidental room charges
  6. I realize my duties are as outlined below:

    1. Duties Throughout Convention:

      1. Any chaperone that is unable to attend an event or leaves an event must arrange with another chaperone to be responsible for their delegates. The AJAS committee is NOT responsible for making these changes for that person.
      2. Report suspicious persons, packages etc. If there is someone you don’t recognize, inform an AJAS Committee person assigned to that event, the AJAS Safety Supervisor or the AJAS National Director.
      3. You must instruct your student delegates that they MUST NOT travel anywhere without your permission, especially outside the convention hotel. Students must be only travel in groups of three or more.

    2. Duties for Wednesday Evening and Early Thursday morning:

      1. Attend the Student Orientation Meeting (Wednesday evening).
      2. Attend the Chaperone Meeting (Wednesday evening).
      3. Meet with your student delegates—“Chaperone-Delegate Meeting” (Wednesday evening after Chaperone Meeting).
        1. Introductions (Be sure your delegates know who you are and you know who they are.)
        2. Get room number from each delegate and be sure they know your room number.
        3. Make sure the AJAS Safety Supervisor has ALL room numbers for your delegates.
        4. Review convention guidelines--code of conduct, curfew, behavior, security, wear badges, etc., including consequences of inappropriate behavior. Explain to your delegates that they are REQUIRED hold to the conduct standards. Remind them to be respectable towards all AJAS chaperones.
      4. Inform National Director in writing of late arriving delegates who did not attend the Student Orientation Meeting and/or the Chaperone-Delegate Meeting (needs to be done Wednesday evening)
      5. Meet with delegates who did not attend Student Orientation Meeting and/or Chaperone-Delegate Meeting to review convention guidelines at earliest possible date.

    3. Duties for Housing:

      1. Do hall/room checks at random times throughout convention. Nightly room checks are mandatory.
      2. Do not give permission for mixed sexes to be in the hotel rooms. Mixed sexes are to meet in the student lounge.
      3. If you observe inappropriate behavior from AJAS delegates (including those from other states) IMMEDIATELY inform the AJAS Safety Supervisor or the AJAS National Director.

    4. Duties for Bus Trips

      1. Be sure you know the bus assignments of your delegates.
      2. Instruct your delegates who are not on the same tour bus as yourself that they will be assigned to another chaperone on the other bus tour.. Make sure your delegates know the results of abbreviate bus behavior.
      3. Check to be sure delegates have their badges with them when they get on the bus. Bus roll-call—Bus sponsor will ask you if all your delegates are on the bus before leaving each site.
      4. If a student delegate is not present for a bus leaving at an assigned time, you as their chaperone will be left at that site to locate and supervise that delegate. It is the responsibility of the chaperone to be sure your student delegates on each of their buses, that they will be assigned to another chaperone, that the students know the name of that chaperone and that chaperone has a written list of those delegate names. It is also the responsibility of the chaperone to either meet their delegates after tours. Students are to be supervised at all times during an AJAS event.

    5. Duties for Student Poster Board and Oral Presentations:

      1. Make sure delegates are dressed appropriately in business attire.
      2. Be sure delegates know their board number assignment, have set up their display and are present for their poster board presentations.
      3. Be sure delegates know their room assignments for oral presentations and have equipment needed for presentation.
      4. You must attend all oral presentations.

    6. Duties for Student Lounge: Make sure that your delegates directly GO and COME from the student lounge.

    7. Other duties: Make sure that your student delegates DO NOT go anywhere alone. You must be with your student delegates when they are outside the convention hotel.

  7. I realize that failure to comply with these stated rules could/will result in reassignment of the delegates to which I am assigned and/or notification to my state academy and/or home school district.
  8. This Consent and Release Agreement contains the entire agreement and understanding between and among the parties as to the subject matter hereof, and shall be binding upon the undersigned and the undersigned's heirs, administrators, executors, and assigns. I have read and understood each paragraph of this document and will comply by the guidelines outlined herein. I understand that by agreeing to this Consent and Release Agreement, I give up valuable rights.




Thursday February 16th is our tour day.

Please select your first, second, and third choice.

Do NOT select the same choice more than once.

Tour First Choice (*)

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Tour Second Choice (*)

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Tour Third Choice (*)

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AJAS committees are vital to the success of our conference.

Please select how you would like to help.

First Comittee (*)

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Second Comittee (*)

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Third Comittee (*)

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Date of Arrival (*)

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Date of Departure (*)

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A $120 AAAS Registration Fee and $300 AJAS Conference Fee will be added to the housing amount.

Housing (4 Nights) (*)

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Roomate(s)

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Payment By

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Payee (if Other)

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By submitting my registration, I understand that any payments not received by 12/15/2011 will result in cancellation of my registration.

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