Just The Beginning - A Pipeline OrganizationiLead Law & Leadership Conference 2024 Application

Page 1 - Program Information

Disclaimer

Please note that this application requires information and signatures from the student's parent/guardian. You will be allowed to save this application and come back to it at a later time.

The application deadline varies for each program city, but it generally occurs around one month prior to the program's start date or once capacity is reached. Early registration is strongly advised.

iLead Law & Leadership Conference

The iLead Law & Leadership Conference is a one-day workshop focusing on law and leadership skills for high school students. During the workshop, students will work with judges, lawyers, and leaders in the legal community who are committed to supporting their academic growth and legal career aspirations. Lunch, prizes, and program material provided!

Please note: the program is FREE to all students, with public transportation passes available to students who express a need. Housing is NOT provided.

A complete application includes a completed application form, parent signatures, and a brief statement of interest.

Program Cities

(Houston, TX Capacity Reached For This City, Please Select From One Of The Other Options) (Richmond, VA Capacity Reached For This City, Please Select From One Of The Other Options: Waitlist) Nashville, TN. October, 2024Seattle, WA August 12-14, 2024

Page 2 - Application

Student Contact Information

Student First Name

Middle Initial

Student Last Name

Street Address

City

State

Zip Code

Student School Email

Student Personal Email

Student Cell Phone

Student Date of Birth

Year in school as of the 2023 -2024 school year

9th Grade10th Grade11th Grade12th Grade

School Name

School City

School State

Transportation

JTB can provide a stipend for local transportation only (i.e. bus/train within the metropolitan area). Will you need a stipend for your transportation to and from the program?

YesNo

Please provide the name of the bus/train service.

Parent/Guardian Contact Information

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email

Parent/Guardian Cell Phone

Optional Secondary Parent/Guardian Contact Information

Secondary Parent/Guardian First Name

Secondary Parent/Guardian Last Name

Secondary Parent/Guardian Email

Secondary Parent/Guardian Cell Phone

Optional Secondary Contact Information

JTB will send copies of program information to an additional email. Please include the email address of a teacher, coach or mentor who you would like to receive copies of important information.

Secondary Contact First Name

Secondary Contact Last Name

Secondary Contact Email

Page 4 - Additional Application Materials

Supporting Documents

Statement of Interest: Please type a statement of interest in the box below. Your statement of interest must be between 100 - 150 words and should tell us about you, your ambitions, and why you would like to participate in a program designed to immerse young students in the legal field (i.e. was there an event, issue, or a movement that made you interested in the law?)

Page 5 - Signatures and Consent

Privacy Policy

Any information supplied to Just The Beginning – A Pipeline Organization (JTB-APO) by participants, parents, volunteers or others will be used solely to fulfill their program participation and shall not be shared for any reason unless permission is granted by the the participants, parents, volunteers or others to share such information. JTB-APO does not sell or share participants, parents, volunteers or other lists. Participants, parents, volunteers or others who supply JTB-APO with their postal address or email address may be contacted periodically for solicitation purposes and/or with information regarding upcoming events. Participants, parents, volunteers or others may request to be permanently removed from JTB-APO’s mailing list by contacting us via email, phone or postal mail. All requests to be removed from JTB-APO’s mailing list shall be honored. participants, parents, volunteers or others who supply JTB-APO with their telephone number shall only be contacted by telephone regarding their program participation.

Nondiscrimination Policy

The officers, directors, committee members, employees, and persons served by this organization shall be selected entirely on a nondiscriminatory basis with respect to age, sex, race, religion, national origin, and sexual orientation. It is the policy of JTB-APO not to discriminate on the basis of race, creed, ancestry, marital status, gender, sexual orientation, age, physical disability, veteran’s status, political service or affiliation, color, religion, or national origin.

Program Requirements

If selected, students are expected to arrive promptly on each day of the iLead Law Leadership Conference and attend the entirety of the program, except in case of emergency.

I have read and understand the above:

Parent/Guardian Electronic Signature:

Date

COVID-19 Policy

If selected, students are expected to adhere to the COVID-19 policies and procedures administered by the host law school. JTB will follow up with further instruction and guidance if necessary.

I have read and understand the above:

Parent/Guardian Electronic Signature:

Date

COVID-19 vaccination card

Special Accommodations

Special accommodations are available for program participants who meet eligibility criteria and sufficiently document their request. Program participants who have a documented disability covered under the Americans with Disabilities Act, as amended, or a scheduling conflict due to a religious Sabbath or a military appointment may request special accommodations. Program participants who require language-based accommodations, such as interpreters, materials in a different language, or assistance with general language needs, can also make their requests by using the section below. All accommodation requests must be submitted with the application.

Please indicate any need for special accommodations. If not applicable, type "N/A."

Photo Release Form

In consideration for my child(ren) being permitted to participate in the Just The Beginning – A Pipeline Organization (JTB-APO) program or activity, I hereby grant permission to JTB-APO and each of its affiliated or subsidiary companies, their successors, agents, and assigns to utilize my child(ren)’s name, voice, and likeness (including, but not limited to, photographs and any video/audio recording of my child(ren)’s appearance at the program or activity) in any and all manner and media, now known or hereafter developed, throughout the universe in perpetuity without limitation and without additional compensation or consideration, notification, or permission, unless prohibited by applicable law.

I hereby waive any right that I or my child(ren) may have to inspect or approve any finished product (including, but not limited to, any blog, newsletters, brochures, videos, slide shows, websites, and/or other materials) or any advertising copy that may be used in connection therewith or the use to which it is applied. I hereby warrant that I have the right to make this release on behalf of my child(ren) and that my granting this waiver and release and the rights conveyed thereby will not infringe upon the rights of any third party. I hereby assign all rights, title, and interest my child(ren) or I may have in any and all media now known or hereafter developed in which any or all of my child(ren)’s appearance, name, voice, and/or likeness have been captured in connection with the program or activity to JTB-APO, along with full rights of assignability. I understand and agree that any photographs and/or video/audio recordings I make of my child(ren) at the JTB-APO program or activity shall be used solely for my and his/her/their private, noncommercial use, and that absolutely no sale, transmission, distribution, or commercial use of any such photographs and/or video/audio recordings or descriptions are permitted.

I have read and understand the above:

Parent/Guardian Electronic Signature:

Date

Informed Consent - Evaluation Participation

As a routine part of all JTB-APO programs, students are asked to participate in an evaluation process that is integral to ensuring the program best meets the needs and interests of the young people that we serve. As a parent or guardian, your consent is requested prior to the beginning of the program. Students will be informed of the evaluation components of the program and will be required to participate in the program evaluation. There will be no negative consequences for students who choose not to participate or who discontinue their participation at any point. The information gathered as part of the evaluation will be kept confidential and will not be utilized to evaluate or provide feedback to any specific student; rather the evaluation data as a whole will be analyzed to better understand the students’ experiences. By signing the form below, you are giving your consent for the student to participate in that evaluation process.

I have read and understand the above:

Parent/Guardian Electronic Signature:

Date

General Release of Liability

Do you have any food allergies?

YesNo

Known Allergies and/or Medications Include:

Other Food Related Restrictions include (i.e. halal, vegan, vegetarian, etc.):

FOOD ALLERGIES: An environment free of allergens, including but not limited to food allergens, cannot be guaranteed by Just The Beginning – A Pipeline Organization (JTB-APO). While reasonable efforts will be made to serve food not containing known allergens as an ingredient, vendors may prepare meals in a facility that uses nuts, soy, wheat and other known allergens. Therefore, JTB-APO cannot guarantee that any particular food product is free of all traces of any particular allergen, that consumption of a food product will not result in some form of allergic reaction, or that the student will not come into contact with any allergens while participating in the JTB-APO programs.

The undersigned acknowledges and agrees that s/he is aware of such risks and that participation in the program will expose the student to food, activities and persons that may result in exposure to allergens and injury and, in that regard and assuming such risks, the undersigned hereby fully releases and discharges JTB-APO from any and all liability and/or responsibility to the student, the undersigned, or any third party for injuries to my child(ren), and/or any direct, indirect, punitive, incidental or any damages that arise out of or relate to student’s participation in JTB-APO programming and exposure to food allergens.

MEDICAL TREATMENT: In connection with any injury my child(ren) may sustain or illness or other medical conditions my child(ren) may experience during his/her/their participation in or attendance at the program, I authorize any emergency first aid, medication, medical treatment, or surgery deemed necessary by the attending medical personnel if I am not able to act on my child(ren)’s behalf. I agree to assume all liability for any expenses incurred in such an emergency (including, but not limited to, transportation, hospitalization and x-rays). I also understand and agree that JTB-APO will notify me if my child(ren) becomes ill during program hours, and I will arrange to have my child(ren) picked up immediately from the program. Further, I waive and release JTB-APO and its owners, officer, directors, employees, agents and independent contractors from any and all liability for personal injuries, illness, loss or damage to property.

PROGRAM POLICIES AND RULES: I understand and agree that my child(ren) must abide by the JTB-APO policies and rules and the instructions of the JTB-APO organizers, employees, staff and volunteers at all times, and that my child(ren)’s failure to do so will result in his/her/their immediate dismissal from the program.

ASSUMPTION OF RISK: I understand that my child(ren), and each participant in the JTB-APO program(s), will be engaging in activities that may involve the risk of serious personal injury, illness, permanent disability, dismemberment, and death, and that also involve the risk of severe economic and property loss and damage. I understand that these risks may result from the actions, negligence and failure to act of my child(ren) and others (including, but not limited to, other participants in JTB-APO program(s), and the organizers, employees, staff and volunteers, if any) and the condition of any real or personal property, facilities, or equipment used during the program.

I also understand that there may be risks involved in any and all activities which my child(ren) may participate which are not known to me, my child(ren), JTB-APO, or its organizers, directors, members, employees, staff, counselors, and volunteers, if any, and may not be foreseen or reasonably foreseeable by any of the foregoing entities or persons at this time or at the time of the program. For my child(ren) participating in a JTB-APO program, these activities and associated risks may include transportation via motorized vehicle (including, but not limited to shuttle, coach, and/or school bus) and walking between different segments of the program during program hours. Permission is granted to JTB-APO to transport my child(ren) via motorized vehicle between different segments of the JTB-APO program to or from any outside facilities used by JTB-APO during the program. In consideration for my child(ren) being permitted to participate in the JTB-APO program, I, on behalf of my child(ren), assume all of the foregoing risks, including, but not limited to, the risk of any negligence by other participants or by JTB-APO, and its respective owners, partners, directors, officers, employees, and agents, and the risk of injury caused by the condition of any real or personal property, facilities, or equipment used during the program, and accept personal responsibility for any injury (including, but not limited to, personal injury, disability, dismemberment, and death), illness, damage, loss, claim, liability, or expense (including reasonable attorneys’ and professionals’ fees), of any kind or nature, that my child(ren) or I may suffer arising out of or in any way connected with the JTB-APO program or my child(ren)’s participation in or attendance at the JTB-APO program.

I REPRESENT THAT I HAVE THE AUTHORITY TO ENTER INTO THIS AGREEMENT ON BEHALF OF THE STUDENT AS THE STUDENT’S PARENT OR LEGAL GUARDIAN. I EXPRESSLY AND VOLUNTARILY ASSUME ANY AND ALL RISKS ASSOCIATED WITH PARTICIPATION IN JTB-APO PROGRAMMING. IN CONSIDERATION FOR THE STUDENT BEING PERMITTED TO ATTEND AND PARTICIPATE IN JTB-APO PROGRAMMING AND ANY AND ALL OF THE ACTIVITIES THAT ARE OR MIGHT BE ASSOCIATED WITH JTB-APO, ON THE STUDENT’S BEHALF, I RELEASE AND FURTHER AGREE TO INDEMNIFY, DEFEND AND HOLD HARMLESS JTB-APO, INCLUDING ITS BOARD MEMBERS, MANAGERS, OFFICERS, OWNERS, STAFF, EMPLOYEES, AGENTS, CONTRACTORS, REPRESENTATIVES, VOLUNTEERS, INTERNS AND INSURERS, FROM ANY AND ALL CLAIMS, DEMANDS, ACTIONS, CAUSES OF ACTION, LAWSUITS, EXPENSES OR LOSSES (INCLUDING ATTORNEYS’ FEES) WHATSOEVER THAT COULD BE BROUGHT BY ME, THE PARTICIPANT OR A THIRD PARTY ACTING ON BEHALF OF THE PARTICIPANT OR ME FOR ACTS OR OMISSIONS RELATED IN ANY WAY TO, OR ARISING OUT OF, JTB-APO PROGRAMMING.

I have read and understand the above:

Parent/Guardian Electronic Signature:

Date

American Indian or Alaskan Native	Asian
Black or African American	Hispanic, Latino, or of Spanish Origin
Middle Eastern or North African	Native Hawaiian or Pacific Islander
White	Other
Prefer not to answer

$100,001 and above	$88,001 to $100,000
$88,000 to $55,001	$55,000 to $35,001
$35,000 to $18,501	$18,500 or less
Prefer not to answer