2020 high school Study trips Italy Heritage Science & Technology

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2020 high school Study trips Italy Heritage Science & Technology
high school Study trips

              Italy

Heritage Science & Technology
       (Art, Architecture and Archaeology)

               2020

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2020 high school Study trips Italy Heritage Science & Technology
Dear Parents and Students
CIML Canada is excited to introduce you to our summer trips to Italy— unique,
educational and life-changing experiences. Not only will students be able to experience
first-hand insights from the ancient and classical Roman world, but be able to do so
with world-class professors and teachers from Italy and Canada and alongside students
from across Canada! These courses have been specially prepared to include lessons
and inquiry based learning.

Our students come from public and private schools across Canada and are from a
variety of ethnic, religious and social backgrounds. Our teachers and staff are hand-
picked to provide the safest and most quality experience for the students.

I hope the information we have prepared in this booklet will prove helpful, but feel free
to give us a call if you have any questions.

Kathie Krahn                                 Kelly Zhao
Administration                               Administration
CIML (Canada) Culture Media Ltd.             CIML (Canada) Culture Media Ltd.
1-604-850-4825                               1-604-783-7106

        cimlcanada@gmail.com
        Website: www.cimlonline.ca
        Facebook: CIML Canada

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2020 high school Study trips Italy Heritage Science & Technology
Academics
Heritage Science & Technology
This exclusive study trip to Italy has been designed for Gr. 11 and 12 students
who have an interest in art, archaeology or architecture and who would like
to prepare for a university academic discipline in these areas. This course is
substantially different from the Ministry of Education courses and therefore
provides additional study that is complementary to and in addition to other
courses available. This course will provide 4 course credits, subject to ap-
proval by the student’s BC school, and the possibility of 4 additional credits
for a Capstone Project.

Students will have opportunity to learn from professors and world experts
from Italy as well as Canada. The experiential learning will include lab expe-
rience, advanced technology, art experience and practical field work. An en-
quiry-based learning experience with hands-on learning results in an optimal
educational experience. Imagine getting to know and work with students
from across Canada who have the same interests and goals.

Amelia Italy is the major focus of the trip. It is a small walled city in Umbria,
about an hour north of Rome and having a wealth of history and culture to
discover including a 2,500 year old city wall , architecture from the 1st centu-
ry AD, Roman roads, ancient mosaics and cisterns as well as medieval archi-
tecture and art. In addition, CIML is launching an archaeological excavation
in the spring of 2020, where students will be part of the discovery of artifacts
from the 7th to 4th century BC up to the Romanization.

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2020 high school Study trips Italy Heritage Science & Technology
Academics (continued)
The University of La Tuscia in Viterbo is a scientific partner in our archaeolog-
ical dig as well as an excellent source for studies in art and art restoration.
Students will get a taste of the rich history of Viterbo, including the Palace of
the Popes and other museums and churches.

Art experience will include visiting and viewing art in multiple museums and
churches, but will also include making items such as a small mosaic from Ital-
ian marble, a fresco, and an icon.

To conclude the study trip, the students will spend several days in Rome, ob-
serving architecture, art and history while making connections to the artists,
architects and archaeological artifacts studied in Amelia.

Dates for the trip: Saturday March 14 to Saturday, March 28.

Cost of the trip: $5,800 CA; $6,100 CA after December 7, 2019

       cimlcanada@gmail.com
       Website: www.cimlonline.ca
       Facebook: CIML Canada

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2020 high school Study trips Italy Heritage Science & Technology
Team Members
      Yang Yu, President
      Yang Yu graduated from Lanzhou Fashion Workers University in 1995 and moved into
      the Chinese arts and entertainment industry in 1998.

      Yang became vice president of the parent company, the CIML (Beijing) Culture Media
      Co. Ltd. from 2007 to 2016, with the purpose of enhancing the friendship between Chi-
      na and Italy. She promoted cultural exchanges and produced hundreds of world-class
      arts, cultural exhibitions, performances and events. By 2016, the company had grown
      into an international corporation focused on cultural exchanges, exhibitions, perfor-
      mances, education and the creative arts.

      At this time, CIML Canada was formed and Yang Yu was appointed as CIML Canada’s
      president. Under her leadership, CIML Canada has connected with international part-
      ners, hosted first-class exhibitions and cross-cultural events and performances,
      launched into the archaeology field, provided advanced educational programs, and is
      contributing to the Canadian arts and culture industry.

      Kelly Zhao, Administration
      Kelly was born in Haerbin, China. She obtained her degree from UBC’s Sauder School
      of Business in 2007, her CPA/CGA in 2011 and has worked in the arts and culture in-
      dustry in Vancouver since 2016, assisting with the Beijing Opera for six performances
      in BC. Kelly understands the benefits of taking adventures and would like Canadian
      students to experience an educational, cross-cultural trip.

      Kathie Krahn, Administration
      Kathie has worked in education in BC for 25 years. She travelled for a year to 28 coun-
      tries throughout Europe and the Middle East with her husband and five children in a
      motorhome. Kathie is passionate about discovering new things, trekking hillsides, and
      learning from different cultures and people. Art and archaeology are two of her favor-
      ite things.

      Dr. Alessandra Bravi, Archaeologist
      Alessandra was born in a small medieval city in Umbria and studied Greek and Roman
      archaeology in Rome, where she obtained her degree and doctorate. As research as-
      sistant in Heidelberg and Perugia, she was involved in projects about Greek, Roman
      and Byzantine visual culture, cultural transfer and constructing identities of marginal
      societies in the Greco-Roman age. She likes to re-experience the secrets of ancient
      places and immerse herself in the beauty of the stratified past in the landscapes of
      Italy, a melting pot of Etruscans, Umbrians, Greeks and Barbarians living side by side
      and changing through contact with one another. She is a member of the Faculty of
      Philosophy at Ruprecht-Karls University in Heidelberg.
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2020 high school Study trips Italy Heritage Science & Technology
Team Members
      Dr. GianCarlo Pastura, Archaeologist, La Tuscia University
      Giancarlo Pastura is Research fellow of Christian and Medieval Archeology at Università
      della Tuscia (UNITUS). He has promoted several studies on Christian and Medieval
      archeology and on technologies applied to cultural heritage. He participated on
      archaeological surveys and excavations in Italy (San Valentino, San Leonardo,
      Pietramara and St. Eutizio catacombs), integrating the archaeological research also with
      the application of remote sensing technology (ground penetrating radar, laser scanner,
      etc.). He directs the archeological museum in Soriano nel Cimino (Viterbo) and the Orte
      underground (Viterbo) complex. He coordinates the research project in Vallerano,
      Vasanello and Bassano in Teverina and collaborates with several institutions. He worked
      on the Project CLIMA (Cultural Landscape risk Identification, Management and
      Assessment), JPI Cultural Heritage Plus, 2015-2018, for the archaeological research and
      for geophysical surveys.

      Riccardo Passagrilli, Cultural Director, Amelia
      Riccardo graduated from the University of Rome “ La Sapienza” with a degree in Eco-
      nomics and since 2009 has been responsible for the Cultural Heritage Sector of the mu-
      nicipality of Amelia.

      In this position he has been following many projects on behalf of the municipality of
      Amelia. He is the project manager of “The Amelia Project. Clay and Bronze. Daily Life
      and Power in Ancient Amelia between Umbrian Ethnical Identity and Romanization”;
      signed in November 2017 between CIML and the municipality of Amelia.

      Nicola Alessandro, Technical Consultant
      Alessandro graduated from the Polytechnic University of Turin in 2003 and holds a de-
      gree in Architecture. He specialized in Specialization School in Architecture and Land-
      scape Heritage of the Polytechnic University of Turin in 2010. Alessandro is part of the
      Nicola family, world famous restorers of Nicola Restauri in Aramengo, Italy.

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2020 high school Study trips Italy Heritage Science & Technology
Safety and Supervision
The safety of our trip participants is of utmost im-         Safety & Supervision During the Day
portance to us. We take very seriously our responsi-
                                                             High school students are required to travel in groups
bility to ensure that the trip runs smoothly, that the       of 6 or more students at all times accompanied by an
students can exercise some independence while un-            adult supervisor. During free time, high school stu-
der the responsibility and supervision of chaperones
                                                             dents will have opportunity to participate in organized
and teachers and that the educational component of           activities, study, have lunch in restaurants or cafes,
the trip is of unequaled quality.                            visit local sites, or do some shopping. An adult super-
                                                             visor will be in attendance with the group.
Direct Staff Supervision
Parents can be assured that our chaperones, teachers         Safety & Supervision at Night
and administrative people are always close by in the         After dinner, students may study, stay in their room,
same castles, hotels, hostels and residences and             take part in organized activities or visit local sites. If
providing a good selection of supervised group activi-       students leave the hotel/hostel/residence, they must
ties during free time.                                       sign out in groups of 6 or more students and be ac-
                                                             companied by an adult supervisor, and sign in togeth-
                                                             er before curfew.

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2020 high school Study trips Italy Heritage Science & Technology
Curfew                                                                dent at the appropriate times. This medication and instructions
For high school students, curfew is set at 10:30 pm and any stu-      must also be listed on the student’s health form.
dents returning after curfew will be grounded. Overnight stays        1.   If a student is demonstrating symptoms of a contagious ill-
away from the program are not permitted—no exceptions.                     ness such as fever, stomach ache, nausea, etc., he or she will
                                                                           not be admitted on the trip. If a student contracts lice or
                                                                           any contagious illness, he/she will be separated from the
Contacting Staff                                                           group until the issue is resolved or the student is sent home.
In case of emergency, staff can be reached by phone at on a 24-       2.   Reported food allergies will be accommodated where possi
hour basis.                                                                ble. It is recommended that students with allergies bring
                                                                           along several appropriate snacks to have ready as a backup
                                                                           plan.
Checking In on Your Teenager                                          3.   All students and staff will be made aware of any life-
Facebook posts will be available to parents on a regular basis.            threatening allergies within the group as a safety precaution.
Students, teachers and administrative staff will be posting infor-         Parents are asked that any food packed along with their
mation, pictures and videos for access. A signed release will be           teenager is 100% nut-free, peanut-free and sesame-free.
signed by students (if 19 years of age) or by parents for permis-
sion to post pictures and information.                                Insurance
                                                                      Students will need to have insurance coverage against loss of
Health & Allergies
                                                                      possessions, accident and emergency for the duration of the trip.
1.   An authorization to Administer Medication form must be           In order to ensure that all students have uniform and adequate
     filled out and signed by a parent if a student needs medica-     insurance, CIML requires that insurance be purchased through
     tion during the day. The designated staff member will keep       our group provider. This is very important.
     the medication in a secure place and administer to the stu-

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2020 high school Study trips Italy Heritage Science & Technology
Course Changes
CIML reserves the right to cancel any course due to insufficient       Liability & Responsibility
registration of students by February 1, 2020 for Spring Trip or
                                                                       CIML will accept no responsibility for any travel arrangements
May 1, 2020 for Summer Trip. Students will be offered any oth-
                                                                       that are recreational and not related to the academic program
er CIML trip that does not have sufficient enrollment or a full
                                                                       or accommodations.
refund.

Itinerary Changes
CIML has the right to adjust location, itinerary, accommodation
or transportation for any of our trips and to provide alternatives
of equal or better value and quality. Changes will be minimized
if at all possible.

Requirements for Documents & Visa
Passports must be valid for least six months after the student’s
return to Canada. International students residing in Canada
must carry their Permanent Residence card or alternate legal
documentation to verify Canadian residency. Visa require-
ments, if any, for our trips will be posted. CIML Canada will not
be responsible for any students without the required documen-
tation.

Vaccinations
Medical travel advisories and travel recommendations can be
accessed at: phac-aspc.gc.ca/tmp-pmv/index-eng.php Vac-
cinations are the choice and responsibility of the traveler. Since
some vaccinations and medications need to be taken several
weeks prior to departure, please plan accordingly.

Code of Conduct
Administrators, teachers and students on this trip to Italy are
expected to abide by a code of conduct consistent with that in
Canadian schools so that all members feel safe and are safe. This
right to safety comes with the responsibility and accountability
for one’s actions. The following activities are unacceptable on
the trip and CIML Canada reserves the right to dismiss any stu-
dent involved in:
         - possession of or use of cannabis, alcohol or illegal
           drugs. No alcohol consumption is allowed on CIML
           trips.
         - bullying or hate behavior
         - sexual activity or pornography
         - activities considered illegal in Canada or in Italy
         - continued disobedience of the rules
Arrangements will be made for the student to return home
without delay at their own or their parent’s expense. The stu-
dent may also be subject to penalties under the law of the des-
tination country.

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2020 high school Study trips Italy Heritage Science & Technology
Fees Included in Program:                                                      Fees Not Included:
•   Ministry approved credits upon successful completion of the course                          •   Insurance

•   Curriculum                                                                                  •   Gratuities

•   Student login for self-assessment                                                           •   Travel visas, if applicable

•   Accommodations                                                                              •   Airline tickets

•   Breakfast, lunch & dinner daily

•   Entrance fees to sites included in the program

•   Transportation between sites

Daily Timetable (may change on travel days)

7:00 am                                 Rise & shine. Exercise time alternating between yoga, martial arts, running, sports

8:00 am                                 Breakfast plus review of the day’s itinerary followed by discussion

9:00 am                                 Travel or walk to lecture (or museum, activity, etc.)

10:00 am                                Lecture or museum or lab/art/high tech experience

12:30 pm                                Lunch

2:00 pm                                 Lecture or museum or lab/art/high tech experience

6:00 pm                                 Dinner

7:00 pm                                 Academic activity or outing or performance

9:00 pm                                 Snack

10:30 pm                                Self-Assessment Assignment & Curfew

11:00 pm                                Lights out

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Application Steps
 1.   Print off the application form from
 2.   Submit the forms and the total fees ($5,800 or $6,100 Canadian after December 7, 2019) for the trip to our office or
      online. Include copy of Travel Visa if applicable. (Canadian citizens do not need a visa, but international students should
      allow approximately three months.)
 3.   Acceptance Our office will send you confirmation of receipt of the above, an email acceptance package, or a request for
      more information.

Important Information
 1.   Travel Arrangements Please check with the CIML office for protocol on flight reservations.
 2.   Extended Flight Arrangements Students who wish to extend their stay and require other flight arrangements must make
      the arrangements through the travel agency designated by CIML.
 3.   Cancellation and Refunds Cancellation notice is required in writing along with any relevant documentation. A full refund
      of payments is available up to and including January 1, 2020. No refunds are available after April 1, 2020. Refunds will
      not be given for students withdrawing voluntarily during any trip, nor will there be a refund for a student who is asked to
      leave the trip due to use of drugs, use of alcohol or disobedience of the program rules.

                 Deadline

      Upon registration                Full payment is payable by credit card. Medical Insurance and Cancellation Pro-
                                       tection Plan must be purchased at this time and be paid in full. An email con-
                                       firming the application receipt will be sent to the email on the registration form.
      10 days after application date   Students will receive an Information Package by email/mail.

      2 weeks after application date Students are required to provide a copy of their passport. International students
                                     will need to allow 3 months for obtaining a Visa.
      December 7, 2019                 Final date for cancellation with full refund.

      December 31, 2019                Final date for cancellation with partial refund.

      January 15, 2020                 All fees are 100% non-refundable.

      March 2020                       Orientation sessions

      March 14, 2020                   Students depart for Spring Break program. Students must arrive three hours
                                       prior to flight departure.
      Upon Return                      Course documentation sent to student’s school and home. Collaboration with
                                       school regarding capstone project presentations.

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Important Dates for Summer Trip
                  Deadline

          Upon registration           Full payment is payable by credit card. Medical Insurance and Cancellation Pro-
                                      tection Plan must be purchased at this time and be paid in full. An email con-
                                      firming the application receipt will be sent to the email on the registration form.

          10 days after application   Students will receive an Information Package by email/mail.

          2 weeks after application   Students are required to provide a copy of their passport.

          January 1, 2020             Final date for cancellation with full refund.

          February 28, 2020           Final date for cancellation with partial refund.

          April 1, 2020               All fees are 100% non-refundable.

          May 2020                    Orientation sessions

          July 4, 2020                Students depart for July programs. Students must arrive three hours prior to
                                      flight departure.

          Upon Return                 Course documentation sent to student’s school and home. Collaboration with
                                      school regarding capstone project presentations.

Medical Insurance & Cancellation Protection
Students will need to have insurance coverage against loss of possessions, accident and emergency for the duration of the trip.
In order to ensure that all students have uniform and adequate insurance, CIML requires that insurance be purchased through
our group provider. This is very important.
CIML strongly recommends the purchase of the Medical Insurance & Cancellation Protection Plan at the time of registration.
This insurance is available to Canadian residents who have health coverage valid within their province of residence.

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Frequently Asked Questions
How early do I need to apply?
Early application is recommended in order to ensure a space in the program. In the event a trip is cancelled by CIML
Canada due to insufficient enrollment, students and parents will me notified as soon as possible.

Will I need a passport? Yes, all participants will require a passport that is valid for at least six months after the antici-
pated program return date. International students residing in Canada must carry their Permanent Residence card or
alternate legal documentation to verify Canadian residency.

Will I need a visa? Canadian citizens will not need a visa, but international students may need three months’ wait time
in order to obtain a Visa to Italy. CIML Canada recommends starting the Visa application process in adequate time, at least
three months in advance of the trip. CIML will not be responsible for any students without the required documentation.

Will there be any free time? During free time, high school students will have opportunity to participate in organized activities,
study, visit restaurants or cafes, visit local sites, or do some shopping. An adult supervisor will be in attendance with the group.

Will there be a curfew? For high school students, curfew is set at 10:30 pm and any students returning after curfew will be
grounded. Overnight stays away from the program are not permitted—no exceptions.

What kinds of things should I pack? Students will receive a packing list at pre-trip Orientation, but are advised to pack lightly
as they will be carrying all of their own luggage. A cell phone and/or laptop computer will be required. Students will have access
to laundry facilities or may choose to handwash their clothing and hang it to dry.

What is the recommendation regarding the amount of money to bring? Students should bring enough money to cov-
er purchases made in their free time, such as museum entrance, restaurant food, water, public transit, gelato, movie
tickets, or souvenirs.

Can I request a specific roommate or classmate? Yes, roommate requests can often be accommodated, but seating on
the airplane cannot be guaranteed.

When about flight arrangements? Flight costs and airline tickets are the responsibility of the students.

Will I meet the other students on this trip before departure? A pre-trip orientation session is a good place to meet
fellow students and the adults going on the trip. If a student lives too far away to participate in the pre-trip orienta-
tion, the leaders can include that student by Skype or by connections to other students.

What are the accommodations like? Our accommodations are comfortable and safe in multiple occupancy rooms in a
hostel or castle. The chaperones are in nearby rooms in the same facility.

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Frequently Asked Questions (Continued)
How many students will be on the trip?
Our trips are geared for 15-20 students, with 3-4 administration
people from Canada.

What textbooks or course materials are required? There are no
textbooks required for this course, but the team leaders may pro-
vide materials to the students, either in paper format or electronic
format, so a laptop computer or ipad will be required. Student will
be required to submit assessments daily. The certified teacher will
be assessing students by their engagement in the course, which is
in experiential learning format.

Will all meals be included? All meals will be included at the hostel
or restaurants as a group, but students will have opportunity espe-
cially on excursions to explore local restaurants and gelato shops.
If students leave the hotel/hostel/residence, they must sign
out in groups of 6 or more students and be accompanied by
an adult supervisor, and sign in together before curfew.

What if a student has dietary restrictions or allergies? It is im-
portant that we know about these restrictions ahead of time and
we will forward this information to our main accommodation pro-
viders. At time of airline ticket purchase, students should notify
the airline.

Are vaccinations required? Medical travel advisories and travel rec-
ommendations can be accessed at: phac-aspc.gc.ca/tmp-pmv/index-
eng.php Vaccinations are the choice and responsibility of the traveler.
Since some vaccinations and medications need to be taken several weeks
prior to departure, please plan accordingly.

Are there optional excursions? Optional excursions are not covered un-
der the program fee because we feel that the educational program
offered is full and has considerable variety. CIML will accept no responsi-
bility for any travel arrangements that are recreational and not related to
the academic program or accommodations.

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Contact Us
Kathie Krahn   1-604-850-4825
Kelly Zhao     1-604-783-7106
cimlcanada@gmail.com
www.cimlonline.ca
Facebook: CIML Canada
220-3671 Westminster Hwy, Richmond, BC V7C 5V2

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Educational Camp Application Form
Date of Application: __________________________
                         Year / Month / Day

                                                                                                 1 CIML STUDENT #
PERSONAL DATA                               PLEASE PRINT CLEARLY IN ENGLISH                        (For previously enrolled students)
 2 NAME:                     First               Middle           Last                           3 ENGLISH NAME:

 4 DATE OF BIRTH:                                     5 AGE:                                     6 GENDER:
   Year         Month                Day                                                              Male       Female
 7 CITIZENSHIP:                                       8 COUNTRY OF RESIDENCE:                    9 EMAIL ADDRESS:
                                                                                                                          @

PROGRAM APPLICATION and FEE:
 10. PROGRAM:                                        11 DATE OF CAMP::                           12 PROGRAM FEES:
  1. Italy – Spring                                                                                 $
  2. Italy - Summer
  3. Winter Camp - Vancouver

 13 APPLICATION FEE                                  14 MEDICAL INSURANCE                        15 HOMESTAY FEE:
    (none for Italy trips)                           (Optional for students with Travel Insur-       ………… x $______ = $
                                     $______.       ance):

                                                                + $______ per day = $
 TOTAL FEES PAYABLE:                                      PAYMENT RECEIVED:                      DATE:
 TOTAL                                 $______             Wire     Cheque No.
                                                          Other

STUDENT MEDICAL INFORMATION
 Does the participant have any food/drug allergies? If so, please list.

 Does participant have any medical condition that the program should be aware of?             Yes     No

 If Yes, please give additional information:

 Father’s Name:                                                                     Mother’s Name:

   Address in Home Country:

   Home Phone Number:                                            Business Phone Number:                            Fax:

   Email:

   Does this student currently have Canadian Medical Insurance?               Yes    No

                                                                         16
If yes, please give Care Card # or Private Medical Insurance Policy #:

 NOTE: All students attending must have medical coverage.

LEGAL GUARDIAN OR CONTACT PERSON IN VANCOUVER AREA

Name

Relationship to the Family

Address student will be staying at while in Canada

Home Phone:                                     Work Phone                                   Cell Phone

Fax #:                                          Email Address:

Agent’s Name:                                                                                OR    Same as above

Name of Company                                                                              Phone #

Cell Phone #                                    Fax #                                        Email Address:

EMERGENCY CONTACT PERSON IN VANCOUVER AREA

Does this student need Airport Service?              Yes      No

If student needs homestay placement, please fill out the following, as well as the Student Homestay Application:

Arrival Flight/Date: _________/________ Time: ______ Arrival Flight/Date: __________/________ Time: ______

Mother Tongue: _______________________________ Level of English:                 Beginner      Intermediate

Traveling with another student or group? Name(s): ________________________________________________________________

Does this student need Homestay Placement?         Yes      No Has the student every been in a homestay before?        Yes   No

(Please note that children in School Grades K-3 are not eligible for Homestay and must stay with parents.)

Homestay Preferences: Family with children:      Yes       No If yes, please check one of the following:

  Around the same age as student(s)       Older than Student(s)          Younger than Student(s)       No Preference

Family with pets:   Yes      No    If yes, please check one of the following:       Any     Please Specify _____________________

Important: Is there any food you cannot eat? Please specify _______________________________________________________

What are your hobbies and interests? __________________________________________________________________________

                                                                    17
SIGNATURE OF STUDENT
 I hereby certify that the information I have provided in this Student Application Form is true and correct. I understand that submis-
 sion of this application does not guarantee admission to the program offered by CIML (Canada) Media Ltd.

 I agree to abide by all laws of Canada and the trip regulations set up by CIML Canada and its representatives on the trip, as set out
 in the Terms and Conditions of the 2020 Program Guide.

 ___________________________________                _________________________________________________________________
        Signature of Applicant                              Signature of Parent/Guardian for students under age 19 years

 ___________________________________                ________________________________________________________________
      Print Name of Applicant                                         Print Name of Parent/Guardian

 Date: ______________________________

                                      IMPORTANT ADDITIONAL INFORMATION

All students who wish to enroll MUST complete the application form completely before submitting it to the office.

THE APPLICATION FORM MUST BE ACCOMPANIED BY:
  One passport photo.
  Photocopy of the student's birth certificate or passport to prove age

IMPORTANT:
  Please note, CIML (Canada) Media Ltd. reserves the right to refuse admission on the basis of academic or behavior history, or
      class size requirements and limitations.
  Tuition must accompany the completed application.
  Tuition is due in the form of a bank wire transfer, cheque, or money order payable to CIML (Canada) Media Ltd., in Canadian funds,
       or Wire Transfers. (For International Students, the cheque must be verified.)

  Canadian students may attend short school trips on a Tourist Visa. A student visa is not necessary for a program of this duration.
     Note: Processing time for International students from some countries may take 3 months.

AGENCY INFORMATION (IF APPLICABLE)

  AGENCY NAME

  CONTACT

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RELEASE FORM

In consideration of the acceptance of this application for registration, I, intending to be legally bound, hereby for myself,
my heirs, executors and administrators waive and release any and all rights and claims for damages I may have against
CIML (Canada) Media Ltd. and/or its representatives and/or assignees, for any and all damages which may be sustained
and suffered by me or my child (of whom I am parent/guardian) in connection with my or my child’s association with or
registration in this program of study or any activities associated with such program, or which may arise out of my or my
child’s travelling to, participating in, or returning to/from said program or activities associated with it.

 ___________________________________                ______________________________________________________
        Signature of Applicant                            Signature of Parent/Guardian for students under age 19 years

____________________________________                ______________________________________________________
        Print Name of Applicant                                        Print Name of Parent/Guardian

Date________________________________

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