May 10, 2024

Dear 2024 Japanese Academy Student,
Welcome! You have been selected from over 600 applicants as a participant at theVirginia Governor’s World Language Academies. On behalf of the Virginia Department of
Education (DOE) and Randolph-Macon College (RMC), we would like to extend ourcongratulations to you on your acceptance to the Governor’s Japanese Academy. We
look forward to greeting you and your parents at the opening ceremonies.
The following items are included in this student packet:
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Important dates (please post at home)
General participant information for all Academy students
Welcome letter from your Academy director
General daily schedule
Packing list
Checklist with all items to be mailed to the Japanese Academy Director, which
includes the correct mailing address for these items (Please do not mail any forms to
the DOE.)
Includes the request to complete three online questionnaires:
https://forms.gle/yxdDwSqTK9GAUf2V8 – GJA Participation Survey
https://forms.gle/Ak1ZxL7zCF3PUwPt9 – GJA Placement Survey
https://forms.gle/oQiWerpgSj5DDurA9 – GJA Roommate Compatibility Survey● Japanese Academy Student Information sheet● Attachmentso Policies and Regulations Information and Agreement (Attachment A)o Request for Activity Fee Waiver – (Attachment A-1)
o Authorization and Waiver of Liability (Attachment B)
o Computer and Internet Acceptable Use Policy and Agreement (Attachment C)
o Image Use Agreement (Attachment D)
o Medical Information Forms (Attachment E, 3 pages)o Attendance of Off-Campus Religious Services (Attachment F)
o Driving Directions (Attachment G)
o Map of Randolph-Macon College (Attachment H)

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It is important that you and your parents review all items carefully, especially the rules
and expectations, which have been jointly established by the Virginia Department of
Education and Randolph-Macon College.
Attachments A-F must be completed and returned to the JAPANESE ACADEMYDIRECTOR by May 24. Take note of the $75 student fee that should be mailed with all
the completed and signed attachments. Please refer to the director’s checklist for acomplete list of all items to be returned and the correct address for mailing them.
Once again, on behalf of the Governor’s World Language Academies, we congratulate
you on your acceptance to this unique and exciting program. Best wishes as the end ofyour school year approaches.
Best Regards,
Lisa Harris
Coordinator of World Languages
Virginia Department of Education
804-225-3666
Lisa.Harris@doe.virginia.gov

Bartolo Natoli
Program Coordinator
Governor’s Japanese Academy
Randolph-Macon College
bartolonatoli@rmc.edu

2IMPORTANT DATES:(Please post at home)
May 24, 2024

Please mail all signed permission forms and other necessary forms to theJAPANESE ACADEMY DIRECTOR by this date using the address
indicated on the academy checklist.

June 23, 2024
(Sunday)

Opening Day for the Japanese Academy
Check-in
11:00am-12:45 pm

Opening Ceremony
1:30-2:30 pm

ARRIVAL: Make plans to arrive at parking lot H for COVID prescreening
and allow time for the screening test to complete before starting Check-in.
ONCE CLEARED BY STAFF, move your vehicle to Lot I adjacent toAndrews Hall (#61 on map), for immediate unloading only. Once finishedunloading, please expedite the movement of your car to allow the limited
spaces to be used by other families also checking in. You can move yourvehicle closer to the Center for the Performing Arts building (#16) which
will serve as the opening ceremony location. We suggest using Lots D, E,
or street parking, where you can park your car until after the opening
ceremony. Parking is also available in Lot J.
You must check in before 12:45 pm.
Please allow adequate time to move in and unpack before the opening
ceremony. PLEASE HAVE LUNCH BEFORE your arrival.
The opening ceremonies will take place in the Blackwell Auditorium(#16A). Both students and parents should attend the opening ceremony.
Please park in lots D, E or on the street. Faculty/Staff restrictions do not
apply on Sundays.
See Attachments G and H for a map and directions.

July 13, 2024
(Saturday)

Oshibai Project – Student Performance
The students will work together to create and perform a Japaneseculture-inspired stage performance during the Academy. All the students
will be involved in this production project in multiple facets, including as anactor, scene handler, prop creator, or musical accompaniment.
Performance time
3:30-5:30 pm
Location: Randolph-Macon Campus; Cobb-Kesler Theater (16C)

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July 14, 2024
(Sunday)

Check-out and Closing Ceremonies
On closing day, parents should arrive according to the schedule below.
Parking should be the same as for check-in. Families and guests should
attend the closing ceremonies, which will highlight the accomplishments ofthe students over the three-week period and will include the distribution ofcertificates. Please note that the Closing Ceremony will start promptly, sofamilies and guests should leave ample time to complete checkout, findparking for the car once loading has been completed, and find seating inBlackwell Auditorium.
Check-out
10:00-11:30 a.m.

Closing Ceremony
12:00-1:00 p.m.

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GENERAL PARTICIPANT INFORMATIONFOR ALL ACADEMY STUDENTS
ACADEMICS: The courses that are offered during the Academies differ significantly fromtypical high school language courses and change from year to year depending upon the uniquetalents of the faculty. Although grades are not given during the Academies, you will receive
feedback on your work and should be prepared for a rigorous experience.
For the Japanese Academy, students will arrive with a wide variety of Japanese language
skills, with many having no prior Japanese. Students will be divided into language classes
based on existing skill levels and availability of instructors. These classes allow for individual
attention in developing all areas of the language: pronunciation, vocabulary building, grammar
review, and oral proficiency. In addition to daily language classes, you will have lessons on avariety of cultural topics. Please refer to the information provided by your Academy Director forthis year’s exact offerings.
You are encouraged to seek opportunities to speak Japanese with your teachers and resident
assistants (RAs) outside the classroom (e.g., during meals and afternoon/evening activities).
The more engaged you are, the more you will learn!

ATTENDANCE: You are required to be present at all classes, activities, and events, fromregistration on the opening day through the end of the closing ceremony. Any student who mustleave the Academy for any reason during this time will not receive his or her Academy certificate
and should not indicate on college applications or résumés that he or she attended. BRIEF
exceptions may be made in the event of a true family emergency. Please note that weddings do
NOT constitute family emergencies. Students with known conflicts should immediately
decline their invitation to attend so that an alternate may be invited.

CLIMATE: Randolph-Macon College is located in Ashland, Virginia. Our residence hall andclassrooms are air-conditioned; however, it will be very hot and humid during the day.
Temperatures above 90 degrees are not unusual and summer rain showers are common. We
will be walking outside between campus buildings multiple times every day. Use the clothing
advice below and the “What to Bring” list included in the Academy packet to choose appropriate
items to pack.

CLOTHING: Clothing should be casual for classes, lectures, and most activities, but there area few occasions on which you will be expected to dress up – for example, a dress, skirt, or nicepants outfit for females, or a dress shirt, tie, and blazer/jacket for males. Having at least two or
more sets of exercise/gym clothes is highly recommended, as well as clothes for painting,working with liquid inks, or other messy activities. Please bring a sweater or jacket, as
air-conditioned classrooms may feel cold. You will need to wear comfortable shoes; we will bewalking to all activities. It is recommended that you bring two weeks worth of clothes; laundrytime is limited and facilities must be shared by others on campus. Due to the climate, we findthat some students may want to change clothes several times during the day for various
activities.

5Please use the following guidelines when packing. There is a checklist (“What to Bring”) in yourindividual Academy packet that we suggest you follow closely. All clothing, including that for
special occasions such as the Academy Sports Day, should follow the guidelines below.
● Clothing should be neat, modest, comfortable, and appropriate.
● Shoes and shirts must be worn at all times.
● Shorts/skirts/dresses must be at least fingertip length.
● Clothing should avoid spaghetti straps, bare midriffs, cleavage, exposed undergarments, andoffensive messages.
● Outdoor temperatures are usually warm, so bring light, mostly casual clothing.
● Air conditioning keeps academic spaces chilly and warmer attire is recommended indoors.
● Check the PowerPoint presentation (available on the website) to get more information.
.
CORRESPONDENCE/COMMUNICATION WITH HOME: You will not have access to e-mailor telephones during the Academy, so we encourage parents and friends to send frequent letters
via postal mail; this is the only contact Academy students will have with the outside world. You
will be given time daily for correspondence and should bring an ample supply of paper or
postcards and stamps, as well as an address book or pre-printed address labels. Parents may
also send packages with snacks and other goodies from home. Keep in mind that any food items
must be in sealable plastic or Ziploc containers.
INBOUND MAIL: ALL mail, including packages, must be sent via U.S. Mail. Specialdeliveries such as floral arrangements will NOT be accepted by college staff, and academy staff
will not be available. Please check with the Academy Director if you have any questions.
All letters should be addressed as follows:
Student’s Name
Governor’s Japanese Academy
Randolph-Macon College
P.O. Box 5005
Ashland, VA 23005-5505

Packages sent via USPS should be
addressed as follows:
Student’s Name
Governor’s Japanese Academy
Randolph-Macon College
304 Henry St.
Ashland, VA 23005

OUTBOUND MAIL: Student’s written letters will be gathered by Academy staff and posted via
U.S. Mail. Students should bring stamps with them. Stamps may also be purchased at the
R-MC bookstore, but there is no post office on campus. Parents, we suggest that you send yourfirst letter to your child a few days before the beginning of the Academy so that the students will
have something waiting for them on the first day of the Academy. Students, you may even wish
to send a postcard to yourselves. Please practice addressing a letter properly before coming to
the Academy.

E-MAIL: Students will not have access to e-mail during the Academy. Parents may e-mailgeneral questions to their child’s Academy director at VAJapaneseAcademy@gmail.com.
Please keep in mind that Academy staff members are busy with students most of the time andallow at least 24 hours for a response to a non-emergency message.

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TELEPHONE: Academy participants may not make or receive phone calls during theAcademy, except in the case of a family emergency. However, parents/guardians may contact
the Academy Director via several telephone numbers that will be distributed at check-in.
Parents may also e-mail the Director using the Academy address provided above. Please notethat the Academy office is not staffed during the day, as the Director and staff are busy withclasses and activities. Please allow at least 24 hours for non-emergency return calls. In an
emergency, if you are not able to reach the Director immediately, please contact campus
security at 804-752-4710 or by using the numbers that will be provided at check-in.
Students may not be in possession of a cell phone, smartwatch, or other wirelesscommunication device at the Academy. Students found with such devices may bedismissed from the Academy.
Each Academy seeks to promote community among its members, re-creating the culture of thetarget language. This means fostering an environment with limited distractions. Over the past
25 years, we have found that students appreciate the ability to concentrate on new relationships
within the Academy community and leave behind, if only for a short time, the demands andinterruptions that everyday life imposes. The relationships that students build at the Academies
often last into adulthood and many participants keep in touch and participate in informal
reunions for many years. We believe that cell phones impede the fundamental goals of the
Academy experience. To that end, we expect that students and parents will respect ourcommunity formation process by leaving cell phones and other wireless communication devices
at home. This policy is often more difficult for parents to accept than for students, because they
have become accustomed in recent years to being in constant contact with their children.
Indeed, the Academy may be the first time in years that participants will not pick up their phone
at all for an entire day. This is especially jarring for many students given how intrinsic technology
has become to our daily functions. Recent years have seen even more compounded usage,
both educationally and personally. Students should be particularly aware of any “streaks” orother usage patterns that they have become accustomed to participating in with their devices.
Any such goals should be left to a trusted friend to carry on for the duration of the Academy.
Parents wishing more information about this policy should contact Lisa Harris at the Virginia
Department of Education at 804-225-3666 or Lisa.Harris@doe.virginia.gov no later than June 9.

VISITS: As you were advised in the original application materials, participants are not allowed
to receive or make visits during the three-week session. Please understand that theseguidelines are established to ensure that all participants derive maximum benefit from theprogram.

DAILY SCHEDULE: In order to let you make the most of your experience, every day will befilled with classes and activities. Every day will include language classes followed by culturalactivities, lectures, field trips, projects and recreation periods that do not end until shortly before
lights out. Even weekends will be packed with classes and activities.
Please take note of the highly-structured nature of a typical day at the Academies. There isvery little free time and you are expected to participate in all classes and activities. Students
who are accustomed to being independent sometimes have a difficult time adapting to thisrigorous program during which they are under constant supervision by staff members. Please7keep this in mind as you prepare to attend the Academy. In particular, you should not allow yoursleep schedule to shift during summer break prior to the Academy, and should instead prepare
yourself to wake at 7:30 a.m. for each day of the program.
In addition to classes, you will learn traditional crafts and/or dances, get a taste of various ethnic
culinary marvels, attend guest lectures, watch films and animations, and even go on several
field trips (pending the availability of buses) to learn more about your target culture and history.
All of these activities are designed to enrich your learning experiences.
Activities will include a variety of group projects that you will work on consistently over thethree-week period. These vary by Academy but often include video production, newspaper,
theater, chorus/music, and the production of an electronic memory book that will be distributed
to students at the end of the experience. Many of these activities will be highlighted during thefinal weekend of the Academy.

DINING HALL: Students and staff will eat together in the dining facilities at Estes Dining Hall.
The dining hall is operated by Parkhurst. Daily menus can be accessed online athttps://rmcdining.catertrax.com. The summer menu is slightly limited compared to the regularschool year. You should make sure to choose a variety of healthy foods.
It is important that dietary restrictions be listed on the information sheets and that you
communicate your needs to the Academy staff.
The dining hall may be closed for breakfast on the weekends and you will receive breakfast
items in the residence hall, which may include granola bars, bagels, yogurt, fresh fruit, and juice.

EXPENSES: Tuition costs for the Governor’s Academies are shared by the local school
division or private school and the state. (Private schools may make alternate arrangements withparents for their share.) Therefore, the only expenses incurred by participants are fortransportation to and from the Academy; expenses on campus (e.g., laundry and snacks);
spending money for field trips; and the student activity fee of $75 for the Academy T-Shirt,electronic memory book, and other items produced by and for the students during the Academy.
You may pay the activity fee by check for $75 made payable to Randolph-Macon College;please send the fee payment with the other enclosures in this packet. Include the names of thestudent and the Academy on the memo line of the check. Extra-curricular activities fees may be
waived or reduced for economically disadvantaged students and those students whose families
are undergoing economic hardship and are financially unable to pay. Please complete
attachment A1 if you wish to request a fee waiver.
Students will need some spending money while on campus for incidentals such as snacks, andsouvenirs. Experience has shown that $50-$75 should suffice. You may also want change forsnack and drink machines on campus. Please note that laundry cost will be AT LEAST $1.50 aload, and the machines ONLY TAKE QUARTERS. (Don’t forget to bring your own detergent!)
As a student and guest of R-MC, you will be responsible for your own door fob provided to you
for access to the dorms. The replacement cost for the fob is $25~. In the unlikely case that you
lose it, you will be held responsible for the charge by R-MC. Of course, you will also be
responsible for any damage that you cause to property of the Academy, College, or otherpeople.

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FACULTY AND STAFF: The Japanese Academy has a director, two teachers, three teacher
assistants, and two resident advisors (RAs). The staff members are carefully selected and may
include high school teachers, university professors, and other experts in the language. The RAs
are generally college students who are majoring in the language of the Academy, and many areformer Academy students themselves. Because of the unique opportunity to teach and interact
with the brightest and most motivated language students in the Commonwealth, faculty and staff
members often return for multiple summers and many have a great deal of experience with the
Academies.
The Academy maintains an office on campus. Office telephone numbers will be distributed at
check-in. You may reach the program coordinator, Dr. Natoli at 804-752-7276.

HEALTH: The students’ health and well-being are of utmost concern to all staff members. Any
illness, whether slight or severe, must be reported immediately to a member of the staff. The
Director will notify the parents and keep them apprised of the situation.
The R-MC campus is about 14 miles from the Bon Secours Memorial Regional Hospital in caseof emergency. For minor injuries, students will be transported by an approved driver in a college
vehicle to CareNow (https://www.carenow.com/locations/richmond/ashland/)As noted on Attachment E, parents are responsible for the payment of all medical andemergency services rendered. Please plan for this when providing spending money or otherpayment options to your student.
Any and all medications (including over-the-counter drugs) must be in original containers andmust not exceed the amount needed for the duration of the Academy. All medical information,
including permission to use over-the-counter drugs, must be included on the attached Medical
Forms. Neglecting to relay any medical or emotional conditions as well as information aboutprescribed medications and/or allergies could compromise your child’s health and safety andwould be grounds for dismissal from the Academy. Please also note that students must beable to self-medicate, as Academy staff are not allowed to dispense ANY medications tostudents.
Students who suffer from any chronic illness or condition, even if there have been no bouts or
occurrences recently, should anticipate that the rigorous demands of the Academy might trigger
a bout of the condition. Students should come with medicine prepared for any such rareoccurrences.
Students must have health insurance and parents must submit proof of coverage.
Parents of students with no insurance coverage should contact the program coordinator prior toarrival to make arrangements for camp insurance.

RECREATION: Students will participate in organized recreation at the R-MC Brock Center, as
well as fields and indoor pool. Tennis courts are also available. Field trips, which may include
trips to local parks, are subject to the availability of local school buses for transportation.
However, students should bring any basic portable recreational equipment that they alreadyown: bathing suit, beach towel, sunscreen, insect repellent, water bottle, tennis shoes,
comfortable walking shoes or hiking boots, and other items such as a Frisbee, football, etc.
When packing clothing for recreation, keep in mind that you may encounter multiple instanceswhere you need a set of sportswear between opportunities to do laundry.

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The Academy encourages physical fitness and we know that some of our participants areserious athletes. However, while there is some time for organized recreation built into theschedule, it will not be possible to accommodate an athlete’s rigorous training schedule. Any
student may sign up for supervised jogging on Monday through Saturday mornings before
breakfast; however, you will not have access to sports facilities during free time.

RELIGIOUS SERVICES: Interested students may attend religious services within close
walking distance of the residence hall. Please know that selections are limited, although we will
make our best effort to accommodate your needs. A teacher or RA also attending services willaccompany you. Students wishing to attend services must return the signed permission form
(Attachment F), giving parental permission to attend services off-campus. This form also
indicates which services are available.

RESIDENCE HALL: Male and female students will live in separate areas of Andrews Hall.
Male and female students will be able to meet only in common meeting areas. RAs will live inthe dorm with you and will be available at all times. Specific regulations will be discussed upon
arrival. Please see the R-MC Web site for photos and other information athttps://www.rmc.edu/offices/residence-life/housing-information/residential-options/andrews-hallStudents will live in suites of four students with shared bathrooms. The residence hall is
air-conditioned and rooms are comfortable but sparse. Rooms are furnished with twin beds orbunks, desks, dressers/closets, and an overhead light. The beds are extra long and it may beeasiest to use an extra flat sheet on the bottom instead of a fitted sheet. The mattresses arecovered in plastic for hygienic purposes, so we strongly recommend bringing a mattress pad.
You may also want to bring photos from home or other decorations for your rooms. Don’t forget
to bring basic cleaning supplies as needed; bathrooms will be cleaned once a week by R-MC
staff.
Please feel free to bring snack foods and drinks to save spending money on site. All food must
be kept in sealable containers (Ziploc bags, airtight containers, etc.).
Laundry facilities are in the residential complex, and they cost at least $1.50 per load for thewasher and $1.50 for the dryer. Students should bring a supply of laundry detergent andquarters.

STUDENT CONDUCT: We are fortunate to serve the brightest and most motivated language
students in Virginia, and all of you have been highly recommended by your teachers andschools. Therefore, disciplinary infractions are rare and 99 percent of Academy students finish
the program with no problems. However, each summer the Academies typically dismiss a few
students, most frequently for cell phone use or possession. In all cases of disciplinary issues orconcerns, parents will be informed as soon as possible.
Academy directors, staff, and the host site program coordinator may exercise disciplinary
measures, including dismissal from the Academy, after giving the student notice and an
opportunity to present his or her version of what occurred. This informal hearing will be held assoon as possible after the alleged misconduct. In the case of any student whose presence
poses a danger to self, others, or property, the student may be removed from the Academy
immediately. Dismissal must be approved by the program coordinator and DOE Coordinator ofWorld Languages.

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If you are dismissed from an Academy prior to the closing, we are required to notify your publicschool division superintendent or private school headmaster and will send copies of thedismissal letter to your public school principal, your nominating teacher, and your parents. Your
local school may take additional disciplinary actions, at its discretion. Students that have been
dismissed will not receive an Academy certificate and should not indicate their attendance oncollege applications or résumés.
You are expected to follow all rules and guidelines set forth in these materials, as well as any
additional guidelines given out during the Academies. Due to the highly structured nature of the
program, we would like you to be aware of the following rules in advance:
You are expected to:●
Be on time (don’t hold back your group and delay the next group);●
Be prepared (bring whatever you need for classes/activities);●
Show respect and consideration to others;●
Maintain a positive attitude and contribute positively to the community spirit of the
Academy;●Be responsible for belongings, especially the door fob;●
Wear your lanyard with name tag at all times (you must scan the door fob to enter the
residence hall);●
NEVER be in rooms or on halls of the opposite sex;●
Not go anywhere outside of the residence hall without a staff member;●
Not use telephones, smartphones, smartwatches, or e-mail;●Sign up in advance for certain activities (ex., to attend religious services or to go
jogging);●
Turn off the lights at lights-out;●
Cross streets at an intersection or crosswalk carefully.
SUPERVISION AND SECURITY: Students are accompanied by staff members at most times
when moving about the campus and when in the common areas of the residence hall. Staff
members do have cell phones and are able to contact one another or emergency services in theevent of a problem.
All persons entering the dorm must have the appropriate door fob to do so.

11Welcome to the Japanese Academy!
2024年5月10日
Dear Student and Parents, こんにちは！
Congratulations on behalf of the staff of the 2024 Virginia Governor’s Japanese Academy. We areall excited to have you at the Academy and cannot wait to welcome a new group of outstanding
Japanese students this summer.
Our Academy has a tradition of providing an intensive yet exciting academic study of Japanese
Language and culture. In 2020, the Academy transitioned to an online learning format, whichbrought both blessings and challenges. Here at the Academy, we continued to hope for the chance
to give students the immersive experiences that are a hallmark of our Academy – wearing
traditional Japanese clothing, eating sushi, even simply trying to use chopsticks. In 2022, theAcademy returned to being held in person, and we were once again able to offer our students all ofthese experiences, and more.
This year, we are incredibly thankful to be able to continue with our in-person format. Students will
participate in face-to-face Japanese language classes, conducted at several learning levels toaccommodate students of various proficiencies. The instructors of the Academy will teach culturalclasses to include Japanese traditional cooking, yokai (Japanese ghosts), benshi comedy, andmore. Academy participants will certainly have the opportunity to study the culture of Japan from anarray of perspectives. Additionally, students can look forward to participating in a Japanese tea
ceremony, as well as creating art using classical Japanese methods. Regarding the Japanese
language classes, students are expected to fill out the placement survey by May 24th so as toinform us which language level they are comfortable with.
During this summer, we expect you to grow, learn, and expand your knowledge of and experienceswith Japanese language and culture. The staff of the Academy are all here to support and help youon your personal educational journey as you build a passion for Japanese studies. This being said,
please come motivated and ready to challenge yourself, and never stop learning.
Please review your comprehensive welcome packet and guide for the Academy. This student
packet includes a list of things to do in order to prepare for the Academy. Please make sure thatboth parents and student carefully read the entire packet to fully understand the Academy and its
requirements.
On behalf of the Japanese Academy staff, we are thrilled to meet you and cannot wait to make thissummer a lifelong memory for everyone. For now, good luck with the rest of your school year!
Please contact me at VAJapaneseAcademy@gmail.com should you have any questions orconcerns.
All the best,
Kyle Maclauchlan
マグラクラン カイル
Director, Governor’s Japanese Language Academy122024 GJA GENERAL DAILY SCHEDULE (TENTATIVE)

Daily Schedule from Monday to Friday

Saturday Schedule

7:30 Wake-up call
8:00 Radio exercise
8:15 Breakfast
9:00 Morning language class
12:30 Lunch
1:30 Guest lecture
3:30 Research group work/study time
5:30 Dinner
6:30 Activity (Guest lecture/Culture class etc)
9:00 Nightly meeting
10:30 Curfew
11:00 Lights out

7:30
8:00
8:15
9:00
12:30
1:30
3:30
4:00
6:30
9:00
10:30
11:00

Wake-up callRadio exercise
BreakfastMorning language class
Lunch
Afternoon topic-based class
Recreation
Cooking Japanese foodFilm night/Culture activities
Nightly meeting
Curfew
Lights out

Sunday Schedule
8:00
9:00
12:20
1:30
3:30
5:30
6:30
9:00
10:30
11:00

Breakfast
Flex time (optional religious services)
Lunch
Culture activity
Recreation
DinnerCulture activity
Nightly meeting
Curfew
Lights out

2024 GJA Field Trip Schedule (tentative)
Wednesday, June 26th
Maymont in Richmond: Japanese Garden tour and picnic at the garden
Virginia Museum of Fine Arts in Richmond
Carytown: Visit Tokyo market and candy shop

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Guest Lectures and Appearances
We plan to have several guest lectures from Randolph-Macon College professors for theJapanese Academy in 2024, combined with several guest performances. These lectures will
expand your knowledge about Japanese culture, art, government, music, and more. We value
the opportunity to share these unique perspectives from each professor’s research area.
Students will be given the opportunity to ask many questions as a part of these lectures, so
please think ahead so you can engage with these topics in ways that are meaningful to you.
The areas that we are planning to cover are listed below. (Please note that the topics maychange due to schedule conflicts.)
●
●
●
●
●
●
●
●

Japanese Yokai
Religious Studies of Japan
Comparative Study of Japanese Government
Film Studies of Japan Featuring Silent Films and Benshi Comedy Performance
Japanese Sangaku Mathematics
Traditional Japanese Cuisine
Ikebana Flower Arrangement
Traditional Tea Ceremony

Oshibai Project – Student Performance
The students will work together to create and perform a Japanese culture-inspired stage
performance during the Academy. The staff members will assist in preparing the stories with thestudents, who will work on them during the course of the Academy. All the students will be
involved in this production project in multiple facets, including as an actor, scene handler, prop
creator, or musical accompaniment. We are all going to learn the story together at the Academy,
so prior preparation is not required. However, if you are able to play an instrument, pleaseconsider bringing it with you to the Academy. Also, please bring a solid black T-shirt with you
when you pack for the Academy.
Please save the date:
Saturday, July 13th 3:30 - 5:30 pm
Reception and Performance of The Oshibai Project
Location: Randolph-Macon Campus; Cobb-Kesler Theater (16C)
Parents: the students will have clean-up duties and their farewell dinner with their fellow
Academy members following the show, so please plan to send them off quickly and meet again
the following day (Sunday) for move-out at 10am and the Closing Ceremony from 12pm-1pm.

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PACKING LIST

WHAT TO BRING to the Japanese Academy:
Carefully read the section on the dress code under General Information. Clothes that reveal
cleavage or the midriff; low-cut, halter, or spaghetti strap tops; short shorts; exposed underwear;
suggestive or offensive messaged clothing; and beachwear for daily use are NOT acceptable.
This applies to all clothing, including athletic, recreational, and dress clothes.
Recommended Clothing:T-shirts or polo shirts (no spaghetti straps) and shorts (at least fingertip length)
Plenty of recreation and sportswear
At least 8 days worth of socks and undergarments
Swimsuit
Bathrobe, pajamas
Tennis shoes, loafers, sandals (at least one closed-toed pair of shoes)
Flip-flops for shower or pool (not recommended for daily wear on campus)
Hats, raincoat or umbrella, galoshes
Sweatshirts, sweaters, and/or jackets for cold rooms –classroom temperature is not adjustable and often cold compared to outside temps; azip-up hoodie or other easily donable item is recommended
Two sets of dress clothes for church or special events such as an evening formal dinner andopening/closing ceremonies.
Students must bring at least one pair of casual long pants (like jeans) and at least one
pair of casual closed-toed shoes (like sneakers or tennis shoes).
A black T-shirt is also a required item to bring in order to perform the Japanese Oshibai.
Essential Items:
A photo ID and Insurance card
Alarm clock and watch (do not bring a phone to use as an alarm!)
Bath linens: towels, washcloths, beach towel
Bed linens: sheets (twin long) and blanket (dorm room may get cold)
Pillow, pillowcase
Mattress pad (size 36”x80”)
Clothes hangers
Laundry supplies: laundry bag, detergent, fabric softener, quarters
Letter writing supplies: envelopes, stationery, address book or labels, stamps
Medicines listed on your medical form, including over-the-counter drugs such as Tylenol
Staff cannot dispense any medications, including over-the-counter medications
Personal toiletries: soap, hand soap, shampoo, conditioner, toothbrush and toothpaste,sunscreen, bug repellent, etc.
Reading lamp (there are overhead lights; a clip-on reading light is really useful!)
Spending money for field trips, snacks, etc.
Trash can, plastic bags
Water bottle – there are (very fast, fancy, and free) water bottle refill stations located in the dorm

15

16

School Supplies:
Backpack or tote bag
Composition notebook
English-Japanese/Japanese-English dictionary
One three-ring binder with loose-leaf paper
200 3x5 index cards
USB storage device
Pens, pencils, erasers, markers, construction or art paper, glue, tape, scissors
Optional Items (but recommended):Three-hole punch (past students really think you should bring this)Band-Aids, small first aid kit, anti-itch cream, aloe, ice-pack, ace bandage
Camera, extra batteries, battery charger (film if camera is not digital)
Iron, ironing board (if used), small sewing kit
Japanese cultural books, games, or other items that may be of interest to others
Japanese traditional costumes (yukata, kimono) if you already own one
Light and portable musical instruments, sheet music
Music (especially Japanese music) and a CD player or
Non-smart, non-internet connected MP3 Player
Other Japanese culture related costumes, clothing, posters, or decorations
Props and costumes for variety or talent shows or skits: hats, costumes, silly clothes, wigs
Sketch books or other art materials
Small sports equipment you may already own: lacrosse stick, ball, gloves, Frisbee
Prohibited Items (do NOT bring any of the following items):
Alcohol, illegal drugs, or other items listed in Attachment A (Policies and Regulations)
Candles, incense, matches, lighters or any other such items
Cooking appliances (toasters, microwave ovens, etc.)
Communication devices of any type (e.g., cell phones, ipad, Apple Watch, Smart Watch,
pagers, computers, televisions, etc.)
Items of value (sentimental or monetary); the Academy is not responsible for lost or
stolen items
Vehicles of any type (e.g., automobiles, bicycles, skateboards, in-line skates, scooters)
Handheld or any form of electronic games
Weapon-shaped items of any kind including but not limited to: wooden swords ornunchaku, metal letter openers, plastic toy knives

If you have any questions about what to pack, please email the director at
VAJapaneseAcademy@gmail.com.

17

JAPANESE ACADEMY CHECKLIST
Please read all materials carefully, then complete, sign, and return the following items to the
Director no later than May 24th, 2024:
Mr. Kyle Maclauchlan
Randolph-Macon College
GFLA Japanese Academy/ Asian Studies Program
304 Henry Street Ashland, VA 23005
1.

_____

This CHECKLIST.

2.

_____

Japanese Academy Student Information Sheet with photo attached

3.

_____

Attachment A: Policies and Expectations Agreement

4.

_____

Attachment A-1: Request for Activity Fee Waiver (Optional)

5.

_____

Attachment B: Authorization and Waiver of Liability

6.

_____

Attachment C: Computer and Internet Agreement

7.

_____

Attachment D: Image Use Agreement

8.

_____

Attachment E: Medical Information with:❑ copy of insurance card and❑ immunization record

9.

_____

Attachment F: Off-Campus Religious Services (Optional)

10.

_____

$75.00 Activity and T-shirt fees (see “Expenses”, pg.7).

One check or money order made out to “Randolph-Macon College”.
Once processed, checks are non-refundable.
Additionally, please complete the following three online questionnaires. The links below can beeasily accessed through the electronic copy of this packet found on thevajapaneseacademy.com website.
1.

_____

https://forms.gle/yxdDwSqTK9GAUf2V8 – GJA Participation Survey

2.

_____

https://forms.gle/Ak1ZxL7zCF3PUwPt9 – GJA Placement Survey

3.

_____

https://forms.gle/oQiWerpgSj5DDurA9 – GJA Roommate Survey

Please sign below indicating that you have read this packet in its entirety, AND completed theonline questionnaires listed above.
Parent Signature: __________________________________________
Student Name (Printed): __________________________________________
Student Signature: __________________________________________

18

JAPANESE ACADEMY STUDENT INFORMATION SHEET

Please Print Full Name of Participant:____________________________________
Print Preferred Name or Nickname:____________________________________
Print School Name and Hometown:____________________________________PLEASE ATTACH
A RECENTHEADSHOT PHOTO
OF YOURSELF*Please do not glue, tape, or staple on thepaper as we need to remove it.
Paperclip only!!
(Photo will be on the wall in the classroom
to make the introduction map of thestudents and will not be returned)

Print Birthdate (Month and Date):____________________________________

Student E-mail: ________________________________________________________*Please provide gmail email address. Please do not list your school email address.
Parent E-mail: _________________________________________________________*Please provide gmail email address.

19

RANDOLPH-MACON COLLEGE
2024 GOVERNOR’S JAPANESE ACADEMYPOLICIES & EXPECTATIONS
Governor’s Academy participants are expected to be of unquestionable character and to be
responsible and mature members of the high school community. They recognize that respect
for others is essential for people who wish to live together in a wholesome environment. This
attitude, coupled with each participant’s personal integrity, is of utmost importance for students
who will share a campus, including facilities, dining halls, classes, field trips, and other Academy
activities for an extended period.
Participants in the Governor’s World Language Academies are guests of the Virginia
Department of Education (DOE), the local school divisions that they represent, and host
universities where the Academy programs are held. Respect for the personnel and the propertyof the host campus is expected and rules specific to that site may be attached to this document.
I.

Responsibilities

It shall be the primary responsibility of students to maintain a climate of mutual respect and trust
in order that the dignity of the individual be protected and the pursuit of opportunities for each
student may be realized. It shall be the responsibility of the Academy directors and others towhom disciplinary authority is delegated to be consistent and uniform in the application of allpolicies and regulations.
II. General Rules
While participating in any activities as part of the Governor’s World Language Academies, nostudent shall violate laws or rules and expectations of the Academies. The following list of
conduct violations is not meant to be all-inclusive. The Academy director or program
coordinator may invoke disciplinary measures for conduct not listed, but which, by common
understanding, a student would know or reasonably should have known would be detrimental tothe maintenance of good order and/or the academic process. Infractions of such rules will
result in disciplinary action and may result in immediate dismissal and possible
prosecution under the law.
1. All students are responsible for the care and preservation of their rooms, study areas, andother residence hall facilities. Damage to school property, including lost room keys or
identification cards, will be repaired or replaced at the expense of the student causing thedamage.
2. All students are expected to participate in all activities of the Academy, including meals,
classes, evening programs, etc. Class attendance is required except as excused by medical
personnel or the Academy director.
3. Students are not allowed to ride in personal vehicles at any time.

20

4. Students may not have cars, motorcycles, bicycles, skateboards, rollerblades, scooters orother vehicles on campus or in the local area during the time the Academy is in operation.
5. Use of the telephone is unauthorized at the Governor’s World Language Academies, sinceoutside contact disrupts the intent to maintain a world language environment. Students
may not use cell phones or other wireless communication devices or have them intheir possession during the Academy. Parents will be given contact numbers for the
Academy directors in case of emergencies.
6. Students of full-immersion Academies (French, German, and Spanish) must speak thelanguage of the Academy at all times and in all situations, with the exception ofcommunication with medical personnel or law enforcement officials. Willful or consistentviolations of this rule will result in dismissal from the Academy.
7. Students must remain within areas specified for their use on the host campus and abide by
the rules set forth for these areas, such as swimming pools, sports fields, etc. This includes
restricted boundaries for field trips and other activities off campus.
8. Students must abide by the curfews established by the Academy director. Absence from thecampus without the director’s prior approval, absence from one’s assigned room in theresidence hall after curfew, visiting under any circumstances a hall or area not assigned to
the Academy, visiting rooms in a residence area assigned to the opposite sex, and harboringguests and visitors may result in immediate dismissal from the Academy.
9. Cheating, plagiarism, forgery, lying, stealing, or any other acts of dishonesty shall not betolerated. This includes unauthorized or illegal use of computers or computer networks.
Access to computers will be arranged by the Academy staff for Academy-related activitiesonly. Students may not have personal laptop computers, palm pilots, or any other similar
device for communication in their rooms or in their possession.
10. Gambling in any form is prohibited.
11. Students shall not behave in a disorderly or inappropriate manner or in any other manner tointerrupt or disturb the operation of the Academy and its activities.
12. Students shall not fight or display or contribute to aggressive behavior that is disruptive or
dangerous.
13. Students shall not willfully or maliciously injure, deface, or destroy the property of the
Academy, the host site, or the property of others.
14. The parents of students who require prescription and/or over-the-counter medications must
inform the Academy director. Prescription and over-the-counter medications must remain in
the possession of the student for whom they have been prescribed, and students must beable to self-medicate. Dispensing prescription medications to others for whom they were notprescribed will result in immediate dismissal from the Academy.

21III. Violations of the Virginia Code Resulting in Immediate Dismissal from the Academy
and Possible Prosecution under the Law
Students who do not observe the following laws as well as others cited in the Virginia Code or
the United States Code will be dismissed immediately from the Academy and will be
subject to prosecution under the law.
1. Possession of Tobacco Products - VA Code Section 18.2-371.2 and related sections
No person under eighteen years of age may lawfully purchase or possess any tobacco
product including but not limited to cigarettes and cigars.
2. Possession of Alcoholic Beverages – VA Code Section 4.1-305 and related sections
No person under twenty-one years of age may lawfully purchase or possess alcoholic
beverages.
3. Possession of Legally Controlled Substances (Drugs, etc.) – VA Code Sections
18.2-250 and 18.2-250.1
The possession, use, distribution, manufacture or sale of legally controlled substances is
prohibited. The possession of paraphernalia in conjunction with drugs or drug residue isprohibited.
4. Possession of Firearms and Weapons – VA Code Section 18.2-308.1
Possession of a firearm, stun weapon, or other weapon on school property is prohibited.
School property is interpreted to include the Academy site since it is administered by the
Virginia Department of Education.
5. Tampering with a Fire Alarm – VA Code Section 18.2-212 and related sections
Any person, who without just cause, calls or summons, by telephone or otherwise, any
ambulance or fire-fighting apparatus, or any person who maliciously activates a manual or
automatic fire alarm in any building used for public assembly or for other public use,
including, but not limited to, schools, theaters, stores, office buildings, shopping centers andmalls, coliseums and arenas, regardless of whether fire apparatus responds or not, shall bedeemed guilty of a Class 1 misdemeanor.
IV. Enforcement of Rules
Academy directors, personnel, and/or the program coordinator may exercise disciplinary
measures, including dismissal from the Academy, after giving the student notice of the charges
against him/her, and, if he/she denies them, an explanation of the facts as known to Academy
personnel and an opportunity to present his/her version of what occurred. This informal hearing
will be held as soon as possible after the alleged misconduct. In the case of any student whose
presence poses a danger to persons or property or any ongoing threat of disruption, the student
may be removed from the Academy immediately, and the notice, explanation of facts, andopportunity to present his/her version shall be given as soon as practicable thereafter.
If a student is dismissed from an Academy, a letter will be sent to the superintendent of the
public school division or headmaster of the private school, with copies to the parents of thestudent, the nominating teacher, and the principal of the public high school that nominated thestudent for participation. Please be aware that local schools may take additional disciplinary
actions, at their discretion. Students that have been dismissed should not indicate on college

22

applications or résumés that they attended the Governor’s World Language Academies. Shoulda student leave an Academy at any time before the end of the program, regardless of thereason, no certificate will be awarded.
V. COVID-19 Policy
The Virginia Governor’s Latin and Japanese Academies are responsible for providing a safe
space for all participants and staff to learn together. Therefore, in an effort to provide such asafe space, the Academies follow the recommendations by the Centers for Disease Control andPrevention (CDC). Vaccination for COVID-19 is not a requirement for admission to the
Academies, but it is highly recommended. Moreover, the Virginia Governor’s Latin andJapanese Academies do not require proof of vaccination for entry. Protocols and procedures forparticipants exposed to or testing positive for COVID-19 align with the policies and proceduresof Randolph-Macon College.
Entry Testing
Upon arrival for Academy check-in on Sunday, June 23, all participants will undergo a rapid
COVID-19 test with a brief nasopharyngeal swab that can be performed by the participant
themselves. If a participant tests positive, that participant will not be allowed to attend theAcademy. This testing is free of charge. All students will also undergo a contactless temperaturecheck. Students presenting with a fever will need to seek further medical screening at CareNow
Urgent Care or similar facility at the discretion of the Academy Director.
Protocols and Procedures
Academy protocols and procedures for COVID-19 are determined by participant proof of
vaccination. Since the Academies do not have the ability to house quarantining or isolating
students, any CDC or Randolph-Macon recommendations requiring quarantine or isolation will
result in the participant leaving the Academies. In case of such a dismissal, the participant will
still receive a certificate of completion for the Academy.
If a participant tests Positive for COVID-19 while at the Academy (regardless of vaccination
status)●Participant will be asked to leave the Academy, and parents/guardians will be contacted
for transportation.

If a participant is Exposed1 to Someone with COVID-19 while at the Academy (regardless of
vaccination status)●

Participant will be asked to wear a mask covering the nose and mouth around others for
10 days and test on Day 5.

_________________________________
1

Exposure is defined as being within 6 feet for 15 minutes or more over a 24-hour period.

23

RANDOLPH-MACON COLLEGE
2024 GOVERNOR’S JAPANESE ACADEMYATTACHMENT A
POLICIES & EXPECTATIONS AGREEMENT
We hereby certify that we have read and understood the rules and expectations that will be ineffect throughout the 2024 Governor’s Japanese Academy. We have kept a copy of thepolicies, and we agree to abide by those rules and expectations during the entire length of the
program.

Agreement by Parent or Guardian
Printed Name of Parent or Guardian:_______________________________________________
Signature of Parent or Guardian: __________________________________________________
Date: _______________________________________________________________________

Agreement by Student
Printed Name of Student: ______________________________________________________
Signature of Student: ___________________________________________________________
Date: _______________________________________________________________________

24

Summer Residential Governor’s School and World Language Academy
Waiver Request for Extra-Curricular Activities Fees
Summer 2024
In addition to the instructional activities associated with the main focus or content area of Virginia’s Summer Residential
Governor’s Schools and World Language Academies, students are provided the opportunity to participate in extra-curricular
activities and events that enrich their summer program. Such activities and events may consist of field trips, local culturalactivities, or educational related programs and usually occur on evenings and weekends throughout the summer, outside of theregular Governor’s School or World Language Academy program. These activities typically provide team building
opportunities, creative endeavors, community and regional insights, and recreational outlets. Each Summer Residential
Governor’s School and World Language Academy collects extra-curricular fees to support these enrichment opportunities toenhance students’ summer experience and/or to provide keepsakes such as customized T-shirts, digital yearbooks, and otherAcademy specific memorabilia.
These extra-curricular activities fees may be waived or reduced for economically disadvantaged students and thosestudents whose families are undergoing economic hardship and are financially unable to pay. Criteria that may be consideredin waiving or reducing extra-curricular activities fees include, but are not limited to, families receiving unemployment benefits
or public assistance, including Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program(SNAP), Supplemental Security Income (SSI) or Medicaid, foster families caring for children in foster care; or families thatare homeless. Student eligibility for free or reduced priced meals may be considered as well.
To receive this waiver, a parent or guardian is required to sign this form and provide proof of eligibility by attaching a
copy of the Notification of Eligibility letter for free or reduced priced meals provided to you by your school or documentation
to support receipt of TANF, SNAP, SSI, Medicaid, unemployment benefits, foster care services, or other documentation ofeligibility.
Please complete the form below and return it along with your Notification of Eligibility for free or reduced priced meals
or documentation to support receipt of TANF, SNAP, SSI, Medicaid, unemployment benefits, foster care services, or otherdocumentation of eligibility to the director of the program to which your child was accepted. Questions about the waiver or
reduction of fees for eligible students may also be addressed to the program director.

☐ Attached is a copy of the Notification of Eligibility letter for free or reduced priced meals.
☐ Attached is a copy of documentation to support receipt of TANF, SNAP, SSI, Medicaid, unemployment benefits,
foster care services, or other documentation of eligibility.
I give my permission for my eligibility status for free or reduced price meals, TANF, SNAP, SSI, Medicaid,
unemployment benefits, foster care services or other documentation to be used only for the Summer Residential
Governor’s School or the World Language Academy to which my child was accepted.
I understand that I give up my rights to confidentiality for this specific purpose only.
Student’s Name ____________________________________________________________PRINT NAME
Parent/Guardian’s Name _______________________________________PRINT NAME____________DATE

Parent/Guardian’s Signature ____________________________________
SIGNATURE____________
DATE

25

RANDOLPH-MACON COLLEGE
2024 GOVERNOR’S JAPANESE ACADEMYATTACHMENT B
AUTHORIZATION AND WAIVER OF LIABILITY
Over the course of the Governor’s Japanese Academy Program, students will have theopportunity to participate in various field trips and other activities. Please sign below
acknowledging that it is your responsibility to follow all rules and guidelines set for your safety
when participating in these activities:_____________________________________
Signature of Academy Participant_________________________
Date_____________________________________
Printed Name of Student

PARENT OR GUARDIAN AUTHORIZATION AND WAIVER OF LIABILITY
I hereby grant permission for my son or daughter, __________________________, to participate in thefollowing activities:
I.

Water-Related Activities
a. Swimming in the swimming pool at the host site for this Academy.
b. Excursion to a river, lake, or state/national park.
_____ I do not wish for my son or daughter to participate in water-related activities.
_____ Please note: My child is a NON-SWIMMER.

II. Other Activities
a. Use of the sport and/or exercise facilities and equipment at Randolph-Macon College.
b. Participation in field trips which may involve lake swimming, hiking, etc. as well as
walking (within restricted boundaries) to and from activities accompanied by a staff
member.
I confirm and certify that my child has no medical or health-related condition that would preclude orotherwise render inadvisable his/her participation in any of the activities for which I have granted
permission. I understand that participation in these activities carries with it a certain amount of risk that I
am willing to accept as a condition of my child’s being allowed to participate in this program. I hereby
release and otherwise agree to hold harmless Randolph-Macon College and any of its officers or
employees from any claims stemming from my child’s participation in this program.

__________________________________
Signature of Parent or Guardian____________________________
Date

26

RANDOLPH-MACON COLLEGE
2024 Governor’s Japanese Academy
COMPUTER & INTERNET ACCEPTABLE USE POLICY
Purpose:To provide procedures for the appropriate use of computers at the Governor’s Japanese Academy.
General principles:
The Academy provides computer equipment and services for academic purposes only. Academic
purposes include those purposes directly related to an Academy assignment. Access to the Internet isprovided to improve learning and teaching through research, collaboration, and use of materials andresources. Access to the Academy computers carries responsibility for the proper use of the computing
facilities. The Academy recognizes that most students are responsible and thoughtful users. The actionsof a few irresponsible users, however, can disrupt and interfere with the rights of all users.
Procedures:
Computer users must abide by the rules set forth. Inappropriate use may result in termination ofcomputer privileges, disciplinary action, and/or other actions determined appropriate, including legal
action.
The following are examples of computer and network use infractions that are prohibited for students:
1. Using the computer for purposes other than academic purposes.
2. System tampering (any unauthorized alteration of operating systems, individuals’ accounts, software,
and/or other programs).
3. Obtaining or using obscene, vulgar, abusive, or inappropriate language, pictures, or other material.
4. Knowingly introducing viruses.
5. Vandalism, including equipment damage and willful tampering of data or software.
6. Attempting to decrypt passwords.
7. Attempting to gain unauthorized higher level of network privilege and access.
8. Attempting to gain unauthorized access to remote systems.
9. Deliberately interfering with other users.
10. Attempting to libel, slander, or harass other users.
11. Unauthorized copying or transferring of copyrighted materials, including, but not limited to music,
movies or videos, or any other violation of copyright laws.
12. Placing copyrighted material on the network without permission of the author.
13. Plagiarizing, which is the taking of someone’s words, ideas, or findings and intentionally presenting
them as your own without properly giving credit to the source.
14. Using the computer for illegal activities.
15. Using commercial advertising or chain letters.
16. Using e-mail without the director’s or a teacher’s permission.

27

RANDOLPH-MACON COLLEGE
2024 GOVERNOR’S JAPANESE ACADEMYATTACHMENT CCOMPUTER & INTERNET AGREEMENTSTUDENT USER AGREEMENT AND PARENT PERMISSION FORM
As a user of computers and Internet services provided by the Governor’s Japanese Academy
and Randolph-Macon College, I agree to comply with the stated Computer & Internet
Acceptable Use Policy of the Governor’s Japanese Academy. I understand that violations of
this policy may result in a loss of access to the Academy computers and Internet services aswell as other disciplinary or legal action.
___________________________________
Printed Name of Student_______________
Date___________________________________
Signature of Student_______________Date

As the parent or legal guardian of the student signing above, I hereby grant permission for myson or daughter to use the computers and Internet services provided by Randolph-Macon
College for the Governor’s Japanese Academy. I have read the stated Computer & Internet
Acceptable Use Policy and understand that individuals and/or families may be held liable forviolations of this policy. Violations may result in a loss of access to the Academy’s computers
and Internet services as well as disciplinary or legal action. Acknowledging that some materials
on the Internet may be objectionable, I accept the responsibility of helping to convey appropriate
standards for my son or daughter to follow when selecting, sharing, or exploring information andmedia.
___________________________________
Signature of Parent or Guardian_______________
Date

28

RANDOLPH-MACON COLLEGE
2024 GOVERNOR’S JAPANESE ACADEMYATTACHMENT D
STUDENT RELEASE FORM FOR USE OF
PHOTOGRAPH, IMAGE, VOICE, PERFORMANCES & APPEARANCES
During this session of the Governor’s Japanese Academy, many photographs and videos of students will be madeduring their activities. Many of these pictures will be included on the Academy USB memory book. Some photos andvideos could appear on the Governor’s Japanese Academy Website, posted by the Virginia Department of Education,or on materials or Websites prepared by Randolph-Macon College. Students will also be asked to evaluate andcomment on the program, and some of their quotes may be used as well. For security reasons, only the first namesof students or no names will be used in the description of these photos and videos, or in identifying the quotes.
I, the undersigned, hereby grant permission to the Virginia Department of Education (hereinafter Department) and/or
Randolph-Macon College (hereinafter R-MC), and their employees, agents, assigns and licensees to photograph mychild and to record my child’s image, voice, performances and appearances.
I hereby grant permission to the Department and/or R-MC and their employees, agents, assigns and licensees to use
my child’s name, picture, photograph, image or other reproductions of my child’s physical likeness, voice andrecording for any and all purposes within the scope of the Department’s role in public education and government
without notifying me in advance. I waive any right to inspect or approve the finished picture, photograph, image orother reproductions of my child’s physical likeness, voice and recording or any printed or electronic matter that may
be used with them or to be compensated for them.
The Department and/or R-MC and their employees, agents, assigns and licensees may use my child’s first name,picture, photograph, image or other reproductions of my child’s physical likeness and voice for any and all purposes
in any medium or format, including but not limited to in videotape, audiotape, film, photograph, television, radio,
digital, Internet, intranet, theater or exhibition. In doing so, I agree to the unlimited distribution, promotion andexhibition of the first name, picture, photograph, image or other reproductions of my child’s physical likeness, voice
and recording.
I agree that I waive and therefore I shall not assert or maintain against the Department and/or R-MC and theiremployees, agents, assigns and licensees any claim, action, suit or demand of any kind or nature whatsoever,including but not limited to, those claims grounded upon invasion of privacy, rights of publicity or other civil rights orfor any reason in connection with the Department’s and/or R-MC’s and their agents, assigns and licensees authorized
use of my child’s name picture, photograph, image or other reproductions of my child’s physical likeness, voice andrecording.
I agree that the Virginia Department of Education owns the pictures, photographs, images or other reproductions ofmy child’s physical likeness, voice and recording created pursuant to this release and all rights related to them.
I agree to release, indemnify and hold harmless the Commonwealth of Virginia, the Virginia Department of Education,
and R-MC, and their respective employees, agents, assigns and licensees from liability against any claims or
damages arising from or related to the use of my child’s first name, picture, photograph, image or other reproductionsof my child’s physical likeness, voice and recording including but not limited to any misuse or distortion by third
parties.
I have read the foregoing and fully understand the meaning and effect thereof and, intending to be legally bound, I
have freely and voluntarily signed this permission for release, without compensation and prior notice.

__________________________
Printed Name of Student_________________________________________________________________________
Printed Name of Parent/Guardian
Signature of Parent or Guardian
Date

RANDOLPH-MACON COLLEGE
29

2024 GOVERNOR’S JAPANESE ACADEMYATTACHMENT E
MEDICAL INFORMATION FORM (p. 1 of 3)
Student’s Name: ________________________________
School: _____________________________________________________________________
Home Address: _______________________________________________________________
City: ____________________ State:_____ Zip Code:________________
Home Telephone Number: (______)__________________
Parent’s/Guardian’s Name(s): ________________________/__________________________

Parent’s/Guardian’s Work/Cell Number(s): (______)________________ / (______)________________
Parent’s/Guardian’s Date of Birth: _____________________/_____________________

Medication (prescription drugs and over-the-counter medication taken for certain symptoms) ispresently being taken: Yes ☐ No ☐ If the answer is yes, PROVIDE A COMPLETE LIST on pp. 3 ofthis form.
Does student have allergies to food, medication, bees, plants, or anything else about which we should be
informed? Yes ☐ No ☐ If the answer is yes, please describe. (Does the student have an inhaler or
epi pen?)

Are there any medical/emotional problems (i.e., asthma, eating disorders, anxiety disorders,mononucleosis, anemia, heart disease, diabetes, depression, etc.) of which we should be aware?

When was the student last ill or hospitalized or has he/she had any recent injuries? Please explain.

Emergency phone numbers (i.e., personal physician or school physician):Name: _______________________ Home (_____)____________

Work (_____)______________

Name: _______________________ Home (_____)____________

Work (_____)______________Name of Accident/Hospital Insurance under which student is covered: ____________________
Certificate #:_____________________________ Policy #:_____________________________
If your child is not covered by health insurance, please consider purchasing a short-term policy
for the duration of the Academy program.

30

MEDICAL INFORMATION FORM (p. 2 of 3)
I give permission for my child, __________________________________, to receive medical andemergency care at the Academy and/or at the host institution and for a physician or other appropriate
medical personnel to treat my child in a manner he/she thinks appropriate, in case of a medical
emergency and/or a problem. I understand that the Academy staff members are not allowed toadminister medications and permit my son/daughter to self-administer the prescribed andover-the-counter medications listed on the following pages of this medical information form. I agree that
all medications shall be in original containers. I understand that I am responsible for the payment of all
medical and emergency services rendered to my child, including transportation to medical facilities.
My son/daughter is allergic to the following medications, including over-the-counter medications (continue
on separate sheet, if necessary):

Please attach:❑❑

A copy of your insurance card for the health policy (policies) that cover(s) your child.
Include FRONT and BACK. Many health care providers require that the card be presented
before care will be provided.
An immunization record for your child that includes the date of the last tetanus shot.

The above information is complete and accurate to the best of my knowledge.
_________________________________
Signature of Parent or Guardian
Address:__________________________
Date____________________________________________________________________________________________________________________________________

Telephone:(_________) _________________________________ - Home(_________) _________________________________ - Work31

MEDICAL INFORMATION FORM (p. 3 of 3)(Make additional copies as necessary.)
Student’s Name ___________________________________
Please provide the following information concerning all medications that your child is currently taking.
Include prescription drugs and over-the-counter medicines that might be needed for headaches,
cramps, insect bites, hay fever, etc. Please send all medications with the child; they will be kept by thechild unless we are notified otherwise. Note that students must be able to self-medicate; staff areprohibited from administering any medications. Where applicable, please include the prescribing
physician’s telephone number.
Name of medication: ___________________________________________________________
Why taken: __________________________________________________________________
Dosage/Frequency: __________________________________ Tel. #___________________Name of medication: ___________________________________________________________
Why taken: __________________________________________________________________
Dosage/Frequency: __________________________________ Tel. #____________________Name of medication: ___________________________________________________________
Why taken: __________________________________________________________________
Dosage/Frequency: __________________________________ Tel. #____________________Name of medication: ___________________________________________________________
Why taken: __________________________________________________________________
Dosage/Frequency: __________________________________ Tel. #____________________Name of medication: ___________________________________________________________
Why taken: __________________________________________________________________
Dosage/Frequency: __________________________________ Tel. #____________________

32

RANDOLPH-MACON COLLEGE
2024 GOVERNOR’S JAPANESE ACADEMYATTACHMENT FPERMISSION FORM FOR OFF-CAMPUS RELIGIOUS SERVICES
Student’s Name: _________________________________As the parent or legal guardian of the student named above, I hereby grant permission for myson or daughter to have the option of attending off-campus religious services during the courseof the Governor’s World Language Academies. I understand that my son or daughter, if he/shechooses to participate, will attend services that are within a reasonable walking distance of thecampus and will be accompanied by one or more Academy staff members.
Students who would like the option of attending religious services during the course of the
Academy should understand that choices are very limited, due to the small number of places ofworship located within a reasonable walking distance of the residence hall.
I give permission for my son/daughter to attend one of the following:☐

Catholic Mass

Sundays, St. Ann’s Catholic Church
http://www.stannscc.org/☐

Methodist Church

Sundays, Duncan Memorial United Methodist Church
http://www.duncanmemorialumc.org☐

Presbyterian Church Sundays, Ashland Presbyterian Church
http://www.ashlandpresbyterian.org/

Please contact your Academy director for other options that may be available. See the Web
sites above for further information about the services offered.

___________________________________
Signature of Student________________________
Date___________________________________
Signature of Parent or Guardian_______________________
Date

33

RANDOLPH-MACON COLLEGE
2024 Governor’s Japanese Academy
Attachment G
DIRECTIONS TO R-MC
ANDREWS HALL, ASHLAND, VIRGINIA

1. Take Interstate 95 or 64 to Central Virginia, 90 miles south of Washington, DC.; 12 miles
north of the intersection of Interstates 64 and 95.
2. Exit I-95 at Exit 92B - Route 54 West (Ashland).
3. Take Route 54 across Route 1 (your third light).
4. About 1/2 mile after Route 1, turn right onto Henry Street (across from the Post Office).
5. Park in Lot H, located on the opposite side of Henry Street from Andrews Hall, andawait your COVID test screening. Do not leave your vehicle until you have been
screened and cleared.
6. Once screened and cleared, move your vehicle to Lot I, across Henry Street and behind
Andrews Hall to unload. Then, move your vehicle to Lots D or E or street parking. (See map
on next page. Faculty/Staff restrictions do not apply on Sundays.)34

Attachment H

35