MTA Technology Youth Tour Application

MTA is pleased to offer The MTA Technology Youth Tour. This will be a one-day tour of the telecom industry and be held at the MTA (Matanuska Telecom Association) Facilities located in Palmer, Alaska. The tour will begin in Palmer and participants will receive a first-hand look at the many functions that go into running MTA, a technology company that specializes in broadband. Lunch will be provided to the participants.

Please submit your completed application and signed photo release below by May 30, 2025.

Full Name*

Date of Birth*

Grade Level (Fall of 2025)*

Address*

City*

Zip*

Phone Number*

Please use valid format.

Parent/Guardian Name*

Parent/Guardian Phone Number*

Please use valid format.

Parent/Guardian Email*

Chaperone Name*

Chaperone Phone Number*

Please use valid format.

Emergency Contact*

Emergency Contact Phone Number*

Please use valid format.

Known Food Allergies

I, , the parent or legal guardian of [Child] grant MTA my permission to use the photographs and video footage captured during educational field trips and visits for any legal use, including but not limited to: publicity, copyright purposes, illustration, advertising, and web content.

Furthermore, I understand that no royalty, fee or other compensation shall become payable to me by reason of such use.

In signing this application you acknowledge and assume all risks associated with participating in this event and represent that you, your minor child, estate, heirs, administrators, executors and assigns, hereby release Matanuska Telecom Association, Inc (MTA), including their representatives, directors, officers, employees, and volunteers for and from and against any and all liability and responsibility whatsoever, for any and all damages, claims, or causes of action that you or your minor child may have for a loss, personal injury, disease or death arising out of any injury or accident sustained by you or your minor child.

Date*

**Attendees are responsible for their own transportation.
**Chaperone is required for attendees.