DOT Registration Step 1 of 9 11% Student DetailsStudent Name(Required) First Last Student School Email(Required) Enter Email Confirm Email Student Personal Email(Required) Enter Email Confirm Email How did you hear about this program?(Required) Facebook Instagram LinkedIn E-Newsletter Newspaper Through a school Through a friend Other As a Diplomats of Tomorrow participant you will be added to our youth e-newsletter, The Messenger, which goes out every month. This newsletter provides you with SDDC and other community events, student publications, news, and scholarship opportunities. If you wish to opt out of receiving this newsletter, please check the box below. You can always opt out later by unsubscribing via Mailchimp. I would like to opt out of receiving The Messenger Student School(Required)What is your experience with international relations and which current global issue are you passionate about? (50-100 words)(Required)Current Grade(Required) 6th 7th 8th 9th 10th 11th 12th PhoneMailing Address(Required)Date of Birth(Required) MM slash DD slash YYYY Of the below options, which most closely reflects your gender identity? Male Female Non-binary Transgender Prefer not to say Other Of the below options, which ethnicity do you most identify with?(Required)(Please note that this language and options are stipulated by DOT's funders and were not determined by the San Diego Diplomacy Council) African American/Black Alaskan Native Asian, Asian American, Pacific Islander, Desi Caucasian Hispanic, Latin(a/o), & Latine Multiracial Native American Native Hawaiian Prefer not to say Other This program is conducted in English.(Required) Yes, I understand this program is in English and confirm that my language abilities are proficient to participate. Parent/Guardian DetailsParent/Guardian Name(Required)Parent/Guardian Email(Required)As a Diplomats of Tomorrow participant you will be added to our youth e-newsletter, The Messenger, which goes out every month. This newsletter provides you with SDDC and other community events, student publications, news, and scholarship opportunities. If you wish to opt out of receiving this newsletter, please check the box below. You can always opt out later by unsubscribing via Mailchimp. I would like to opt out of receiving The Messenger Parent/Guardian Phone (Mobile preferred)(Required)Mailing Address(Required)Second Parent/Guardian NameSecond Parent/Guardian EmailSecond Parent/Guardian Phone (Mobile preferred) ScholarshipDo you require assistance to participate in the Diplomats of Tomorrow program?(Required)The San Diego Diplomacy Council is delighted to offer scholarships for students in need of financial assistance, and/or who identify as underrepresented and underserved in their community. If you'd like to apply for a scholarship, in the following sections you will be asked to please explain why you believe that you qualify to receive a sponsorship for Diplomats of Tomorrow. Yes, I require financial assistance to participate in this program. No, I do not need financial assistance. DOT PaymentTo keep your information secure, we are processing all payments for Diplomats of Tomorrow through Click and Pledge. The below link will lead you to a new tab where you will be able to pay for DOT enrollment.Refund PolicyIf you need to cancel your participation, you will receive a full refund provided you cancel your participation at least 1 week prior to the program start date. To submit a refund request please contact carmelina@sandiegodiplomacy.org. Refunds will be sent via check from the San Diego Diplomacy Council, and we will not issue a refund check until the credit card purchase or check has cleared. Please note that refund checks may not arrive until a few weeks after the refund request. By competing this DOT 2025 Registration form, you are agreeing to the SDDC refund policy. Process payment for the Diplomats of Tomorrow 2025 here:https://connect.clickandpledge.com/w/Form/873b8f53-7453-43c1-aa38-c8f2c703b900 We invite you to complete this form before submitting your payment to the Diplomats of Tomorrow program. However, please note that your registration will only be CONFIRMED once we receive your payment. Scholarship Extra QuestionsIf you are applying for a scholarship, please answer the following questions:What role do you believe young people like yourself can play in shaping international relations and global change? (100-150 words)(Required)How do you plan to use your skills and knowledge in international affairs to make a positive impact in your community or globally? (100-150 words)(Required) Module Selection - Middle SchoolThe below modules are open to students entering grades 6-8.Module Selection - High SchoolThe below modules are open to students entering grades 9-12.Select the module(s) you wish to enroll in:(Required) July 7-11: Introduction to International Relations at La Jolla Country Day School July 21-25: Global Security & Cybersecurity: The New Frontier at Pacific Ridge School Emergency ContactEmergency Contact 1 Full Name(Required)Emergency Contact 1 Relationship(Required)Emergency Contact 1 Phone(Required)Emergency Contact 2 Full NameEmergency Contact 2 RelationshipEmergency Contact 2 Phone Medical DetailsAllergies and Dietary RestrictionsDoes your child have any dietary restrictions? Please explain.If applicable, please provide details about your child's anaphylaxis, including the date and description of the reaction.Over-the-counter medicationsPlease select from the following list any over-the-counter medications that may be provided to your child if needed. Acetaminophen (Tylenol) Antacids (Tums) Antibiotic Cream Antihistamines (Benadryl, Claritin, Zyrtec) Cortaid Calamine Lotion Sudafed Sunscreen Select AllIs there anything we need to be aware of when giving any of the approved over-the-counter medications to your child?Does your child require an EpiPen Yes No Has your child experienced, or is currently experiencing, any of the following conditions? ADD/ADHD Asthma/Inhaler Back Pain or Injury Behavioral Issues Blackouts/Fainting Bleeding Disorder Cancer Chest Pain Crohn's Colitis Concussion Constipation/Diarrhea Seizures Depression Developmental Delays Diabetes Down Syndrome Eating Disorder Frequent Colds Hay Fever Headaches Hearing Problems Heart Disease Hernia High Blood Pressure Irritable Bowel Syndrome Kidney Disease Lice Menstrual Difficulties Mental Health Issues Motion Sickness Neck Pain or Injury Respiratory Ailments Sore Throats Speech Problems Stomach Aches Uses eye glasses or contacts Vision Problems Does your child have any restrictions on activity?Will your child require any special assistance? Please explain.Is there anything else we should know about your child?Doctor's InformationDoctor NameDoctor Contact Details WaiverPlease read through and e-sign the following waiver:Voluntary Consent to Participate in the Diplomats of Tomorrow, Waiver and Release Agreement: San Diego Diplomacy CouncilThe undersigned, being the parents(s) or legal guardian(s) of a minor child ("Student") identified below, agree and consent to my Student's voluntary participation in the Diplomats of Tomorrow ("Programs"). I understand and acknowledge that although La Jolla Country Day School and Pacific Ridge Academy ("Schools") are assisting in the Programs by providing its facilities, assisting in developing the syllabus and learning objectives, and providing a lead coordinator for the Programs, the Programs are being operated by the San Diego Diplomacy Council ("SDDC").In return for the benefits me and my Student will receive from my Student participating in the Programs, I voluntarily release, discharge, waive and relinquish all claims against the Schools and SDDC and their officers, teachers, staff, volunteers, administrators, trustees, agents and employees (collectively "Releasees"), arising out of or related to my Student's participation in the Programs, including, but not limited to, claims for bodily injury, personal injury, emotional distress or other emotional or psychological injuries or damages, property damage, or wrongful death (collectively "Claims"), except to the extent caused by the gross negligence or intentional misconduct of the Schools or SDDC.I understand that the Schools are not an agent of, and have no responsibility for, any third party including without limitation, SDDC, its employees, personnel, consultants, speakers, or contractors, or any sponsor or entity that may provide any services, equipment, training, or activities associated with the Programs. I agree and acknowledge that the Schools and partner organizations are not responsible for the actions of these entities or individuals or any injuries or damage they may cause. I voluntarily release, discharge, waive and relinquish all claims against the Schools and the Schools' Releasees for any Claims arising out of or related to SDDC's or any third party's acts or omissions related to the Programs.Do you authorize the Schools and SDDC to photograph and to make video and audio recordings of my Student, including my Student's participation in the Programs, and to use my Student's likeness, voice, photograph, and name in any and all School and SDDC publications or promotions, in any media whatsoever for any period of time without compensation?(Required) I Authorize I Do Not Authorize Please note if you do not agree to this waiver, unfortunately your child will be unable to participate in the Diplomats of Tomorrow program.(Required) I HAVE READ AND UNDERSTAND THIS AGREEMENT AND I AM AWARE THAT BY SIGNING THIS AGREEMENT I MAY BE WAIVING CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE. THIS AGREEMENT SHALL BE BINDING UPON ME AND MY STUDENT'S HEIRS, LEGAL REPRESENTATIVES, AND ASSIGNS. Guardian E-Signature (Please print your full name)(Required)
