Background of the Organization
Board of Directors
Contact & Social Media
The 2017 Program
Details and Dates
Why you should attend the Summer Institute
10th Anniversary Event
Field Trip to Chautauqua on August 28th
How to register and pay
Previous Summer Institutes
The 2008 Program
The 2009 Program
The 2010 Program
The 2011 Program
The 2012 Program
The 2013 Program
The 2014 Program
The 2015 Program
The 2016 Program
The 2017 Program
I Am Syria
Human Rights Social Media
Book Project Information
The Summer Institute on C-SPAN
How to start a Summer Institute in your area
2017 Teacher Conference
Agenda & Flyer
Plenary Sessions & Speakers
Breakout Sessions & Speakers
Registration & Payment
About the Organizers
10 for 10 Campaign
Other Donor Options
Sponsor a Student Campaign
Registration and Payment Information:
Please note that Google Chrome works best to complete this form.
Parent Cell or Phone Number
Student Cellular Number
Emergency Contact and Their Phone Number
Please include name of contact, phone number, and relationship to applicant.
Name of teacher who told you about the Summer Institute: (optional)
Please describe any health condition which may require EMERGENCY ACTION while he/she is at the Summer Institute? (e.g., seizure, allergy, asthma, diabetes, heart problem, or other problem?)
Does your child have a health condition which may require EMERGENCY ACTION while he/she is at school? (e.g., seizure, allergy, asthma, diabetes, heart problem, or other problem? If so, please describe.
Allergies (Please describe if it applies to you.)
Please describe, if any.
Breakout Group Interests--choose two
Environmental Issues/Climate Change
Responding to Hate and Intolerance
Choose two area of interests that you would like to learn more about:
PLEASE NOTE THAT T-SHIRT SIZES ARE IN ADULT MALE SIZES
How would you prefer to pay? (Payment button is at end of page.)
By Credit Card
In need of financial assistance/scholarship
Please click on one of the following with payment button at the bottom of this page.
PLEASE KNOW THAT BY CLICKING ON THE "SUBMIT" BUTTON BELOW, YOU ARE AGREEING TO THE FOLLOWING FOR YOUR CHILD:
Permission to Participate:
By submitting the above application, I/We give my permission for my/our child to participate in the Summer Institute and understand that there are risks involved with their participation, as well as for any occasional off-campus trips and their associated activities. In consideration of my/our child being allowed to participate in this program, I/we assume to take responsibility for those ordinary and reasonable risks associated with the travel and activities. I/We agree to hold harmless the Summer Institute for Human Rights and Genocide Studies of Buffalo, Inc., its affiliated organizations, employees, Board, agents, and representatives, including volunteer and other drivers, from any and all claims arising from my/our child’s participation. This release agreement does not apply to claims of intentional (criminal) misconduct or gross negligence by the organization, its employees, or volunteers. If such circumstances are proved in a court of law, I/we acknowledge and agree that the Summer Institute can assume no financial liability beyond its actual liability insurance policy in force.
Media Waiver Release:
From time to time during and after the Summer Institute, students may be photographed or videotaped to increase public awareness of the program through newspapers, radio, TV, the web, DVDs, displays, brochures, and other types of media, including our website, Facebook page, Instagram page, and Twitter feed—as well as those of our partners and sponsors. Given that, by submitting the above application, I as a parent or guardian of the registered student above, hereby give the Summer Institute and its staff permission to print, photograph, and record my child for use in audio, video, film, or any other electronic, digital and printed media. This is with the understanding that neither the Summer Institute nor its representatives will reproduce said photograph, interview, or likeness for any commercial value or receive monetary gain for use of any reproduction/broadcast of said photograph or likeness. I hereby waive any right to approve the use of these Works now or in the future, whether the use is known to me or unknown.
Emergency Medical Release:
In case of accident, illness, or other emergency, I/we request that the Summer Institute contact me/us. If the school cannot reach a parent/guardian after conscientious effort, by submitting the above application, I/we give permission for the program’s staff to call paramedics or any licensed physician. If a life-threatening emergency exists, I/we give permission for the Summer Institute staff to call paramedics immediately and then contact me/us as soon as possible thereafter.
I/we authorize and consent to any x-ray examination, anesthetic, medical, dental, or surgical treatment, and/or hospital care which, in the best judgment of a licensed physician or dentist is deemed advisable.
I/we agree to assume the financial responsibility for expenses incurred as a result of emergency transport and/or the previously mentioned services being provided.
Submit and go to Payment Page
Proudly powered by