SkillsUSA Kentucky

Leadership Conference & Skills

Championship
2023 REGISTRATION PACKET

Crowne Plaza
Louisville, Kentucky
April 19-22, 2023

The information in this packet will assist you in registering for the 2023 SkillsUSA Kentucky Leadership Conference and Skills
Championship. All conference registration forms, hotel reservations and hotel reservation forms are due March 17, 2023. If you
have questions please contact Melanie Jamison, SkillsUSA Kentucky Director, at melanie.jamison@education.ky.gov
 2023 SkillsUSA Kentucky Leadership Conference and Skills Championship

The 2023 SkillsUSA Kentucky State Leadership Conference & Skills Championship is almost here! I hope your regional
events have been exciting and rewarding. The 2023 SkillsUSA State Officers and the Frankfort staff are working to ensure
a great SkillsUSA KY State Conference. This year’s theme is Champions at Work: Our Time is Now.

By attending the State Conference, our students benefit from positive leadership activities. They have the opportunity to
learn from and network with SkillsUSA business and industry partners, many of whom are looking for employees. Student
participants will meet industry professionals in their fields of study and gain insights into those careers, all while
experiencing the benefits of participation in competitive events and the overall conference atmosphere.

Another important aspect of the State Conference is the SkillsUSA Kentucky Congress, the decision-making body of
SkillsUSA Kentucky. Student delegates meet to discuss topics that may affect their chapters and members for years to
come. Additionally, interested students will submit beforehand their applications to become SkillsUSA Kentucky State
Officers, the organization’s leadership team. Students can attend the Conference in one of these roles without having won
a local or regional competition. Please encourage your students to take advantage of one of these important SkillsUSA
Kentucky roles!

The registration fee for Delegates or Courtesy Corps members is $50 each. The registration fee for students competing is
$100 for each participant. (All attendees must be registered). If a Delegate or Courtesy Corps member competes in any
contest, the registration fee will be as a competitor. State Officers that will compete will have a $50 registration fee. The
2023 Conference Registration Guide below will assist you in registering for the Conference. If you have
questions or need assistance, contact melanie.jamison@education.ky.gov.

Registration Deadline: All SkillsUSA Kentucky Leadership Conference and Skills Championship registration forms must
be postmarked by March 17, 2023 to the SkillsUSA Kentucky State Office. There is an Early Bird Registration option.

Crowne Plaza room reservations must be completed online and required paperwork submitted to the Crowne
Plaza by March 17.  Make your reservations ASAP, as there may not be any rooms available after the deadline.

 Advisors should follow guidelines for Supervision and Travel of Students CTSO_Operational_Guidelines-
Local.pdf (ky.gov) and CTSO_Travel_Guide.pdf (ky.gov).

 No drones or other types of devices will be permitted during the state conference.

 Students are asked to pick up prizes and have a photograph taken with their contest sponsor immediately
following receiving their medal

 Prizes will be forfeited if procedures are not followed.  Student advisors may pick up prizes; however, no
prizes will be awarded after the close of the 2023 SkillsUSA State Conference for their student.  All other
prizes may be returned to sponsors.

 ALL students qualifying to advance to the SkillsUSA National Conference must attend a meeting following
the close of State Conference.  If your student(s) are attending SkillsUSA National Conference as a
competitor, you must attend this meeting. National packets will be handed out at this time.

 The conference program will be the official conference agenda .

Program changes may be made at the Advisors meeting 6PM April 19 th, it is mandatory for each school to send a
representative advisor to this meeting.
 TENTATIVE AGENDA
Wednesday, April 19, 1:00 p.m. Exhibitor Setup
2023
3:00 p.m. Conference Registration Opens – Closes at 6:00 p.m.
4:00 p.m. State Officer Candidate Testing and Portfolio Submission
6:00 p.m. Advisors Meeting – An Advisor from each school MUST attend this meeting
to receive conference updates and program changes
7:30 p.m. Parade of Champions – Show school spirit by participating
8:00 p.m. Opening Session – Official Dress Required
Immediately Following Opening Session - Officer candidates report for
interviews
11:00 p.m. Curfew – Lights out at 12:00 a.m.

Thursday, April 20, 2023 7:30 a.m. Chair and Judge Orientation
7:30 a.m. Courtesy Corps Team Meeting
7:45 a.m. Shuttles for off-site contests.
8:00 a.m. Skills Contests Begin – Refer to program for details on location,
transportation and specific contest time
9:00 a.m. Leadership Contests Begin – Contestants must report to contest location
at 8:30 a.m.
9:00 a.m. Congressional Committees Meeting
9:00 a.m. Industry Way Opens – Closes at 9:00 p.m.
Noon State Officer Ballots will be posted
1:00 p.m. SkillsUSA Delegate Assembly
1:00 p.m. Skills Contestants Meeting – Contestants must attend in order to
compete
12:30 p.m. Shuttle service begins to off-site Orientations
6:00 p.m. Advisors’ Meeting
7:00 p.m. Karaoke Night
11:00 p.m. Curfew – Lights out at 12:00 a.m.

Friday, April 21, 2023 7:30 a.m. Chair & Judge Orientation
7:30 a.m. Skills Contests Begin – Refer to program for details on location,
transportation and specific contest time
9:00 a.m. Joint Delegate Session
9:00 a.m. Industry Way Opens – Closes at 9:00 p.m.
5:00 p.m. All Chairpersons to return packets to SkillsUSA Headquarters
5:00 p.m. Deadline to Complete Statesman
5:30 p.m. Talent Show Practice
7:00 p.m. Talent and Variety Show
11:00 p.m. Curfew – Lights Out at 12:00 a.m.

Saturday, April 22, 2023 8:00 a.m. Champions Breakfast and Awards Ceremony – Official Dress or
Contest Attire Required. All conference attendees are required to report for the
breakfast and awards ceremony.
 Contestants not wearing official dress or contest attire will not be
permitted on stage to receive awards
  Pictures will be taken immediately following Medal Ceremony and picking
up prizes
 Postsecondary schools will have tables set up to handout scholarships and
information about their schools
11:00 a.m. National SkillsUSA Meeting of 1st Place medalists – All first place
medalists must attend
 SkillsUSA Kentucky Please clip all forms for each contestant
REGISTRATION PACKET together and put in the same order as
listed on the Summary Sheet.

REGISTRATION
All participants must be registered online at https://www.skillsusa-register.org/RegistrationInfo.aspx Each attendee must have completed
the National Leadership & Skills Championship (NLSC1) form in this packet.

Students competing in two (2) contests will pay only one (1) registration fee, but they must be registered online for both contests. Make checks payable to
SkillsUSA Kentucky Association. Conference registration is non-refundable.

All attendees must read and submit a signed code of conduct, personal liability release, and photo release located in NLSC1 form. Send the completed form,
signed release forms, and registration information with payment to Melanie Jamison, Office of Career and Technical Education, 300 Sower Blvd., 5 th Floor,
Frankfort KY 40601.

Regular Registration - $100.00

Non-competing Delegate/Courtesy Corp/Guest - $50.00
State Officer Competing - $50.00
Champions Breakfast for Non-Registered Guests - $40.00

No late registration or on-site registrations will be accepted

NOTE: Guest payments should be included with the school registration packet. Cash and credit cards will not be accepted for Conference Registration.
Receipts will be placed in the school packets at Conference Registration.

STUDENT REQUIREMENTS
Each student must be a joined member of SkillsUSA Kentucky by January 31, 2023, a paid member prior to state conference and registered online for the
2023 State Conference. All contestants must submit a resume to the contest chairperson during orientation of the contest.

MEDICAL RELEASE/INSURANCE
Students must provide proof of insurance. A photocopy (front & back) of the insurance card must be included in the registration packet. Students who do not
have personal insurance and are covered by school insurance are considered as the secondary insurer. A letter from the school must be submitted on
official school letterhead listing the names of students and the insurance policy information. A completed medical release form is also required for each
student.

ACTION SKILLS - EMPLOYMENT APPLICATION PROCESS

Only students with IEP’s compete in Action Skills & Employment Application Process. IEPs for contestants will be verified by the Office of Career and
Technical Education staff.

SKILL AND LEADERSHIP COMPETITORS

Kentucky allows students to compete in two (2) events, one Leadership and one Skill, in accordance with the 2023 Kentucky Official Contests offered;
however, contest times must not conflict with one another. Contests cannot be delayed. Students may have to choose in which contest they want to compete
if contests are at the same time. If a student wins first place in a leadership and skill contest at the State Conference, they must choose in which contest they
will compete at the National Conference.

CONTESTS LOCATION NOTICE:

Some contests are scheduled to be held at the Elizabethtown Community & Technical College. If your school district requires additional approval to travel
outside of Jefferson County, you will need to obtain appropriate approval through your school prior to attending State Conference.

Off Site Contest Locations:

All contestants must ride bus to and from to the contest location. Parents and advisors will not be allowed to transport contestants.

1st Place Winners:

st
No Contestant shall receive a 1 place (Gold) if their score is less than 60% of the possible score available for the contest.
ROOM RESERVATIONS
 See the instructions near the end of this document under SkillsUSA Housing Instructions
 Contact Kathy Lucky klucky@ajshotels.com with any questions.

HOTEL CHECK-IN AND CHECK-OUT

CHECK-IN: Hotel check-in time is 3:00 pm. Buses may unload at the front entrance of the Crowne Plaza. There is parking for buses. Hotel keys and room
assignments will only be distributed to advisors.

CHECK-OUT:
 Check-out is 11:00 am.
 Advisors are responsible for checking students out of the hotel.
 Advisors should check each hotel room for damage prior to departure. There is a cleanup fee if smoking has occurred in the room. Each student
and/or chapter is responsible for any damage to hotel property or any missing items.
 The hotel requests that luggage be placed in the assigned luggage room on Saturday morning to facilitate the room checks and cleaning. Let the
front desk know which rooms are vacated and which room you are holding with luggage.
 SkillsUSA Kentucky assumes no responsibility for charges accrued during conference by its membership, advisors, or others attending the
conference in any capacity.

SCHOOL PACKETS
Individual school packets may be picked up by advisors only between 3:00-6:00 pm (EST) on Wednesday, April 19 th at the SkillsUSA Registration
Headquarters. Name badges are included in these packets and must be worn at all times for safety, to ride buses to contests sites, to compete, and during
all general sessions. Final spelling corrections must be made by 9:00pm on April 19 th.

TRANSPORTATION TO CONTESTS FROM HOTEL

Shuttle buses will provide transportation for students to all Skill contest areas on Thursday, April 20 th and Friday, April 21st. Advisors may ride buses, but
students have first priority. Parents and family members are not allowed to ride shuttle buses. The conference program has details of contest sites and the
transportation schedule.

SKILLSUSA KY CONGRESS
The SkillsUSA Kentucky Congress shall consist of High School Senate/House of Representatives and Postsecondary Senate/House of Representatives
members. Chapters are permitted to have two (2) Senators per chapter and one (1) Representative per 75 members. This is the time to voice the local
chapter’s opinion on SkillsUSA Kentucky matters, as required under the constitution and bylaws, and to elect your State Officer Team for the following year.
For more information, consult the constitution. All chapters in Kentucky are encouraged to send representatives from their chapter whether or not they have
regional contest winners.

STATE OFFICER CANDIDATES

The application for State Officers is available at skillsusaky.com. Please encourage students to apply. Applications are due March 20th. State Officer
Candidates and National Officer Candidates must be prepared to complete the Kentucky Statesman. State Officer interviews will be held immediately
following the Opening Session. Statesman earned at KLTI are acceptable with documentation.

KENTUCKY STATESMAN
Students and advisors are encouraged to earn their Kentucky Statesman pin during SkillsUSA Kentucky Leadership Conference. State Officers and/or
designees will be allowed to sign off for the Kentucky Statesman.

EXHIBITORS
Industry Way will be open Wednesday, Thursday and Friday, students and teachers are highly encouraged to visit the exhibitors! Turn in completed exhibitor
cards at the registration desk to receive a prize.

TOOLS
Please label contestants’ tools before coming to conference. If you have two (2) students competing in the same contest, they cannot share tools and
materials. Check the Technical Standards for the tool list and contest guidelines. Technical Standards are provided online to Professional Members of
SkillsUSA.

NLSC (National Conference)

SkillsUSA Kentucky will handle registration and lodging arrangements for the National Conference. All 1 st Place Winners advancing to Nationals and their
advisors must meet with the State Director immediately following the awards ceremony. Advisors seeking to be part of the official Kentucky Delegation at the
National Conference in Louisville must notify the State Director by April 24 th, 2023. Please note only gold medalist may attend National Conference. If the
gold medalist is unable to attend or chooses not to attend National Conference, the silver or bronze winner may be eligible to attend.  To achieve a gold
medal a contestant must achieve a 60% or above score.
 Online Step-by-Step Registration Instructions
Please follow these simple steps for a successful registration:

1. Go to www.skillsusa.org, login using your username & password.

2. Be sure all participants have first been registered under the membership tab before proceeding. If students are not registered
members, their names will not be allowed to enter a competition.
3. Click on the “Conference” tab on the tool bar.
4. Select “My Registrations” from the pull-down menu.
5. Be sure the Filter Event reads “Kentucky SkillsUSA Leadership Conference & Skills Championship.” Use scroll arrow to pull up event.
6. Click “Add New Registrant” on the left-hand side of screen. (Or, you can go to bottom to get directions to register from an existing
member.)
7. Click on “Select Registration Type”:
 Click on Advisor if appropriate.
 Click on Contestant if student is competing in any contest.
 Click on appropriate Model the individual is setting for (Cosmetology or Nail Care).
 Click Courtesy Corp (CC) if only attending conference to work on the CC team.
 Click Other – Observer for all others (guests, parents, administrators etc.).
 Click Exempt only for State Officer registration that is not competing in a contest.
 Choose other registration types as applicable.
8. Click on “Select School.” Scroll down arrow and click on your school.
9. Click on “Select Member to Compete.” Scroll down arrow to select appropriate member and click.
10. Click on category (skills or leadership).
11. Choose contest
12. Click on “Division.” Click on either High School or College/Postsecondary.
13. Click on “Contest Registration Type.” Scroll down to appropriate contest your student is entering and click.
14. Click on “Save.” Don’t forget to save or all information will be lost.
15. Repeat for each student. After you start you will not have to repeat the first several steps each time unless there’s a problem.
NOTICE: The skillsusa.org website will time out if not in use.
16. As you work your way through this page making sure all areas are filled in all boxes,
 Please fill in all blanks, every question is important information needed by this office. (MAKE sure HOME ADDRESS is
filled in on this page).
17. T-shirts will be ordered this year using a word document. This will not be done on the registration site.
18. Finally, click the “Save Registration.”
19. This will then return you to the Registration Information page with the participant’s name now located in the blue registration box.
20. Once ALL participants have been registered, you can click “Submit Registration” in the upper right-hand corner. This will send the
State Director an email stating your school has finished entering students for State Conference.
21. Last but not least, go to the blue “Conference” pull-down menu and select “Fee Summary.” This should provide you with an invoice.
 2023 Kentucky SkillsUSA Registration Summary Form
Return this form to: KY SkillsUSA, 300 Sower Blvd., 5 th Floor SW, Frankfort, KY 40601

School: School Phone #: ______

Advisor: Advisor Cell #:
Advisor Email:

Advisor Please Complete these These Columns for OCTE Office Use Only
Columns
List all students, advisors M F A
A E D
O
T
Medical Insurance NLSC Student Students T-shirt Covid Code of Offsite
and guests L M V H Release card (copy Form Resume and Req. Spec. order Form Conduct Bus
E A
L
I
S
E
R
Form both sides) or 1 Completed Asst. form Trans.
E O and Letter from PD Test Form
R Consent Principal
Form
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
# of Attendees: ______X $100.00 = __________ Regular Registration
# of Attendees: ______X $50.00 = ___________ Non-Competing Delegates, Courtesy Corps or Guests (other)
# of Attendees: ______X $50.00 = ___________ Competing State Officers

# of Guests: ______X $40.00 = ___________ Champions Breakfast for Non-Registered Guests

TOTAL AMOUNT ENCLOSED $___________ Check No.__________

CAREER AND TECHNICAL STUDENT ORGANIZATION ACTIVITY MEDICAL RELEASE/PARENT
PERMISSION FORM INSTRUCTIONS:
Students, parents/guardians and chapter advisors must complete this form for each student participant as a prerequisite
for the student to attend a career and technical student organization activity. Each chapter advisor must bring the
completed forms to the student activity.
Student Name:____________________________ Parent/Guardian Name:____________________________  
Street Address _____________________________ City ____________________ Zip _______  
Phone (Work) :_________________________ (Home) :_________________________  
Alternate Contact ____________________________ Phone (Work) _________________________  
Street Address _____________________________ City ____________________ Zip _______  
Student’s Doctor ______________________ Phone (W) _______________ (H) _______________  
Doctor Address _____________________________ City ____________________ Zip _______  
Advisor _______________________________ School _________________________________  
Administrator __________________________ School Phone ______________ Fax _____________  
Student covered by group or other medical insurance as follows:  
Provide name of: Insured ______________________________ Insurance Company
__________________________  
Group #_______________________Policy #___________________________  

Please describe completely any medical condition (past or present) being treated, which may recur or be a factor in
medical treatment (include allergies, medicine reactions, disease of any kind, physical handicap, heart or lung
problems, seizures, convulsions, blackouts, etc.) If currently taking medication, state the medication and prescribing
physician and phone number: ____ I give permission for immediate medical treatment as required in the judgment of
the attending physician. Notify me and/or any person listed above as soon as possible. ____
**I do not give permission for medical treatment until I have been contacted.
Parent/Guardian Signature: ___________________________________________ Date: ________________

I CERTIFY THAT THE INFORMATION DESCRIBED ABOVE IS ACCURATE AND COMPLETE TO THE
BEST OF MY KNOWLEDGE. I UNDERSTAND THAT EACH INDIVIDUAL IS RESPONSIBLE FOR HIS/HER
OWN INSURANCE COVERAGE DURING THIS ACTIVITY. I GIVE PERMISSION FOR
______________________ TO ATTEND A KENTUCKY CAREER AND TECHNICAL STUDENT
ORGANIZATION CONFERENCE AND HEREBY RELEASE THE STATE AND LOCAL ORGANIZATION
AND ANY ADULT IN CHARGE OF THE GROUP FROM ANY LEGAL OR FINANCIAL RESPONSIBILITY
WITH RESPECT TO MY PERSONAL OR MY STUDENT’S PARTICIPATION.
Signature of Parent/Guardian ___________________________________ Date: ________________

Signature of Student ___________________________________ Date: ________________

CHAPTER/SCHOOL: ________________________

KY CTSO Operation Guidelines Handbook Local Edition

 KENTUCKY SkillsUSA
COVID WAIVER AND RELEASE OF LIABILITY
To be completed by all Event Participants
This COVID Release and Waiver is in addition to, and does not replace, any other releases of liability, waivers or
documents that have been executed in connection with this Event.
Assumption of Risk: You acknowledge that you are aware that pertaining to the events taking place at the
_________________ on the dates of _______________ (the “Event”), certain risks associated with exposure to
COVID may exist at the Event.
For Parents/Legal Guardians of Minors - As the parent or legal guardian of
______________________________________________ (the “Minor”), by allowing the Minor to participate in the
Event, and by signing this COVID Waiver and Release of Liability, I, on my own behalf and/or on behalf of Minor,
am assuming all risks, responsibility and liability concerning Minor’s and my health and safety and possible exposure
to COVID in connection with the Event.
Release: In consideration for the privilege of Minor participating in the Event, the sufficiency of which is hereby
acknowledged, I, on my own behalf and/or on behalf of Minor, agree to release and to hold harmless Kentucky
Department of Education (KDE), Kentucky SkillsUSA (KY SkillsUSA), a not for profit organization and the
respective directors, officers, representatives, members, agents, employees and contractors of the preceding parties
(hereinafter collectively “Releasees”) from any and all liability, whether caused by negligence of the Releasees or
otherwise, for any claim, judgment, loss, liability, cost and expenses (including, without limitations, attorney’s fees
and costs) arising out of or connected with associated with Minor’s participation in the Event and Minor’s and/or my
possible exposure to COVID. I, on my own behalf and/or on behalf of Minor, hereby warrant that I have read this
COVID Waiver and Release of Liability in its entirety and fully understand its contents. I, on my own behalf and/or
on behalf of Minor, am aware that this document releases Releasees from liability and contains an acknowledgement
of my voluntary and knowing assumption of the risk of injury, illness and death. I, on my own behalf and/or on behalf
of Minor, have signed this document voluntarily and of my own free will.
ATTENDEES WILL ADHERE TO REQUIRED COVID GUIDANCE AS IDENTIFIED BY THE
KENTUCKY DEPARTMENT OF EDUCATION, KENTUCKY DEPARTMENT OF PUBLIC HEALTH,
THE CENTERS FOR DISEASE CONTROL AND PREVENTION, AND LOCAL VENUES.

Signature/ Signature of Parent or Legal Guardian: ___________________________________

Date:______________

Minor Name: __________________________________ Relationship to Minor: __________________

_______________________________________
 2023 Kentucky Skills USA State Conference
T-SHIRT ORDER FORM
(Please Print)

School Name: _______________________________

Primary Advisor: _____________________________
We are excited to be able to offer t-shirts for all of the 2023 State Conference Attendees. The prices are for pre-
ordered shirts. Order form and payment must be included with other registration items and mailed by March 17,
2023.

Shirt Size QTY Price / Ea. Total Due

Small $10
Medium $10
Large $10
X-Large $10
2X-Large $12
3X-Large $12
4X-Large $13
Total T-Shirts:________________ Total Due: _$____________

Note to Advisors: Mail one check from your school to cover all shirts being ordered. Make checks payable to
“Skills USA KY.” The order form and check must be included with other registration items and mailed by March 17,
2023.

You can pick up your pre-paid shirt orders at headquarters at the beginning of the conference.
 Kentucky SkillsUSA
2023 Code of Conduct

STUDENT
I have read the SkillsUSA KY Code of Conduct, liability and photo release page of the NLSC1 and agree to abide by the
guidelines set by the National & Kentucky SkillsUSA Associations. Violations may result in the disqualification from contest(s),
loss of awards, and forfeiture of any prizes and scholarships.

I agree to be financially responsible for damages and charges at the hotel rooms, hotel property, surroundings as well as
purposely causing damage to tools or equipment during a Kentucky SkillsUSA activity.

I also hereby release the Kentucky State SkillsUSA Association, its management staff, as well as, advisors in an official
capacity in the Kentucky SkillsUSA organization of legal or financial responsibility while participating in official SkillsUSA
activity or traveling to or from KY SkillsUSA activity.  

Print name of Student ________________________________________________ Date: ________________

Signature of Student _________________________________________________ Date: ________________

 
Parent/Legal Guardian _______________________________________________ Date: _________________
 
(Students under the age of 18 must have parent or guardian signature.)

ADVISOR
I recommend and verify the above mentioned student is a paid SkillsUSA member and is in good standing with the local
chapter he/she is representing to participate in the Kentucky SkillsUSA Association official activity. 
My school will be responsible for completing all paperwork for registration and transportation of the student to and from the
Kentucky SkillsUSA activity. High School students regardless of age may not drive to SkillsUSA official activity. 

I assume financial responsibility for mentioned student while participating in the Kentucky SkillsUSA activity. 
The attendee has successfully complete safety course applicable for participation in KY SkillsUSA activity.

YES - NO
I also understand ALL fees are Non-refundable.

I understand if signed student fails to comply with the Code of Conduct the student may forfeit all awards, prizes and
opportunity to represent their school and Kentucky at any additional SkillsUSA KY function and could be sent home at their
expense.

______________________________________________________________________________Date: ___________
Signature of Local SkillsUSA Advisor Recommending Student

______________________________________________________________________________Date:___________
Signature of Principal

 
 SkillsUSA Kentucky

Student Travel Consent Form

Release, Waiver, Discharge and Covenant Not to Sue

Event: SkillsUSA Kentucky

Leadership Conference & Skills Championship

Purpose of Travel: Off Site Contests. Students will be transported by Miller Transportation, Inc.

111 Outer Loop | Louisville, KY 40214

Travel Start Date / Time: _April 19-22, 2023 Estimated End Date / Time: April 19-22, 2023 _____

Destination/s: _Louisville and surrounding locations. Certain contests are scheduled to be held at the
Elizabethtown Community & Technical College. If your school district requires additional approval to travel
outside of Jefferson County, you will need to obtain appropriate approval through your school prior to attending
State Conference.

Off Site Contest Locations:

All contestants must ride bus to and from to the contest location. Parents and advisors will not be allowed to transport contestants.

Special Needs-Medical or Other: ______________________________________________

ACKNOWLEDGMENTS AND ASSUMPTION OF RISK.

1. I hereby acknowledge that, as a participant in the above-listed travel activity, I have been advised that
participating in this activity, wholly or in part, carries with it certain risks. I have carefully identified,
reviewed and considered the risks of travel to my destination/s;

2. I hereby acknowledge that I am voluntarily participating in the above-listed travel activity.

WAIVER AND RELEASE OF CLAIMS. I understand the risks, accept those risks, and I hereby knowingly, freely,
voluntarily and intelligently agree to participate in the travel activity. I hereby release, waive, discharge and covenant
not to sue the Kentucky Department of Education, its offices, departments, divisions, agencies, officers, agents,
instructors, teachers and employees (hereinafter referred to as “releasees”) from any and all liability, claims, demands,
actions and causes of action whatsoever arising out of or relating to any loss, damage or injury, including death, that
may be sustained by me, or to any property belonging to me, during the travel activity, including traveling to and
returning from the above-listed destination/s. I voluntarily assume full responsibility for any risk of loss, property
damage or personal injury, including death, that may be sustained by me, or any loss or damage to property owned by
me, as a result of the travel activity, including traveling to and returning from the above-listed destination/s. I further
hereby agree to indemnify and save and hold harmless each of the releasees, both in their official and personal
capacities, from any loss, liability, damage or costs that may incur as a result of my participation in the travel activity,
whether caused by negligence of the releasees or otherwise. It is my express intent that this Release shall bind the
members of my family and spouse, if I am alive, and my heirs, assigns and personal representative, if I am deceased,
and shall be deemed as a Release, Waiver, Discharge and Covenant Not to Sue the above named releasees.

RULES AND REQUIREMENTS. I hereby further accept and agree to comply with all of the KY SkillsUSA rules,
requirements, and policies for student behavior, as well as the instructions of the officials supervising the travel
activity, and agree that the staff have the right to enforce such rules, standards, policies and instructions, and may
impose sanctions for any behavior detrimental or incompatible with the interest or welfare of the staff, the travel
program, or the other students. If my conduct violates any such polices, rules, instructions or procedures, I understand
that I may be required to leave the travel program in the sole discretion of the SkillsUSA agents and representatives,
and I may be subject to further discipline and may be referred to the appropriate local School Board or School District
for further disciplinary or other action.

_________________________________________________ __________________
SIGNATURE OF STUDENT (required regardless of age) DATE

__________________________________________________ __________________
SIGNATURE OF PARENT OR LEGAL GUARDIAN DATE
(required if student is less than 18 years old)

PARENT’S NAME / ADDRESS / PHONE / E-MAIL:

_____________________________________________________

_____________________________________________________

_____________________________________________________

_____________________________________________________

_____________________________________________________

COMPLETED FORMS MUST BE RETURNED PRIOR TO TRAVEL

Equal Education and Employment Opportunities M/F/D

 STUDENTS REQUIRING SPECIAL ASSISTANCE
 
 
 
If you have registered a student who will require the assistance of another person or special accommodations
during the State Competitive Events, please complete the following information and submit this form to the
office of the KY SkillsUSA State Director by registration deadline as described in this packet.
 
Contestant Name: ____________________________________________________________
Contest: ____________________________________________________________________
School: _____________________________________________________________________
Phone Number: _______________________________________________________________
 
Name of Advisor/School Contact who will be attending student to Conference:
____________________________________________________________________________
 
Describe Assistance/Accommodations Needed:
 
_____________________________________________________________________________
 
_____________________________________________________________________________
 
 
_______________ ______________________________________
          Date                 Administrator Signature
 
NOTE:  This form must be submitted with registration forms.  Once received, we will make reasonable accommodations for
contestant to preform to their ability. You may receive a call from KY SkillsUSA office.
 
 SkillsUSA Housing Instructions

To ensure an expedited check-in/out process please review the following reservation and payment
information. Contact Kathy Lucky klucky@ajshotels.com with any questions.
All hotel questions should be directed to the contact above.
2023 Hotel Reservations will be completed at the link below. All information and instructions are included on this
site.

SkillsUSA Kentucky 2023

 Check List
NOTE – Please staple forms for each student
together and put in the same order as listed on the
Summary Sheet
BEFORE YOU MAIL YOUR PACKET
DID YOU…………
Complete the summary page?
Include Medical Release forms? Students under the age of 18 must have
parent or guardian signature.
Include insurance cards (copied front and back) or school insurance
letter (on school letterhead) for students without insurance?
Include Code of Conduct forms? 
Include NLSC Form 1?
Include bus transportation to off-site events permission form?
Include Students Requiring Special Assistance form? (if applicable) 
Include a copy of your online registration?
Include a copy of each competitor’s resume and completed PD test
Complete hotel reservations online and any additional forms
required by the hotel?
Include your check and invoice for registration?
Include your T-shirt order form and check for payment?
Signature: ______________________________________Date: _______
Phone Number: ________________________