Makerspace Application

Makerspace Application

What Task Can We Help You Accomplish?
What is Makerspace?

You might have heard of a makerspace. It’s a buzzword that’s been floating around for a few years now. But what, exactly, is it? A makerspace is a room that contains tools and components, allowing people to enter with an idea and leave with a complete project. The best part is that makerspaces are communal. The goal is to work together to learn, collaborate, and share. Most importantly, makerspaces allow us to explore, create new things, or improve things that already exist.

We are creating our own version of a makerspace for Skills for Life 5.5 (virtual) and Skills for Life 6 (in person), and we want you to be a part of it! We are currently crowdsourcing project ideas (big and small) to fuel our makerspace. We want to help come up with solutions for tasks that you would like help accomplishing. Once we have compiled enough project ideas, our makerspace committee will sort and group them.

Smaller scale projects will be presented at SFL 6 (October 2022, in person), and then Houston area makers will have the opportunity to engineer, build, and deliver a solution during the conference.

Larger scale projects will be assigned to a student or makerspace team tasked to come up with a solution. During the virtual conference (SFL 5.5, October 2021), the teams will conduct focus groups to discover user needs. Over the next year, the teams will work together to translate the user needs into engineering specifications, and then build a functional solution. Solutions will be presented/delivered during Skills for Life 6 in October 2022.

This form will help us gather ideas for our makerspace projects. Please let us know what tasks you would like help accomplishing.

What do you need help with?

As someone who is missing both arms or all four limbs, think of one task/activity that you currently can't do, but want to do. Describe it below and we will work with a team of therapists, engineers, students to crowdsource your need.
Applicant Information
Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender*

MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email*
example@example.com
Phone Number*

Area CodePhone Number
What category does your task or activity best fit into?*

DressingBathingToiletingEatingMeal PreparationHome Management Task (vacuum, mop, laundry, etc)Communication (phone, tablet, computer, etc)Outdoor activity (hunting, yard work, fishing, etc)Car controls/drivingControlling Home Environment (thermostat, lights, etc)Other
Describe the Task or Activity and Your Physical Limitations
Please describe what task or activity you want to accomplish: *
Please describe your physical limitations including your level of amputations as best as possible: *
Have you attempted this activity/task before and if so, what adaptive equipment or gadgets, (universal cuff, button hook, dressing tree, etc) if any, did you use?: *
Did you use a prosthesis to do this task or is your hope to use a prosthesis to do this task? If you have prosthetic arms/legs, please describe them as best as possible.*
Please list any other info that would be helpful for us to know:*
Participations, Release, and Medical Agreement

We do require that this participation agreement be read, filled out, signed, and dated by all participants (or their parent/guardian if under the age of 18) who wish to participate in this Makerspace Activity.

With full knowledge, I accept full responsibility for any injury or accident that may occur to myself, my spouse, or my child while participating in ESFL Makerspace Activities. I give permission for my child to participate in activities that occur at ESFL Makerspace.

For promotional or marketing purposes, Enhancing Skills for Life reserves the right to use any audio, video, and/or photography of participants during Enhancing Skills for Life Makerspace Activities.

I, on behalf of myself, my children, my assigns and my estate, agree to release and hold harmless Enhancing Skills for Life, its officers, board, agents or employees, for any and all claims for injuries, causes of action, or liability related to my or my child's participation in any activity occurring during ESFL Makerspace Activities. This release does not apply to intentional and/or willful acts of misconduct by Enhancing Skills for Life or any of its officers, board, agents or employees.

Should Enhancing Skills for Life, or anyone acting on their behalf, be required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify and hold Enhancing Skills for Life harmless for all such fees and cost.

I have had sufficient opportunity to read this entire document. I have read and understood it, and agree to be bound to its terms.
Acknowledgement

BY ACKNOWLEDGING AND CLICKING THE BELOW BOX, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC CHECKBOX WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
I ACKNOWLEDGE THE ABOVE APPLICATION IS ACCURATE & TRUTHFUL TO THE BEST OF MY ABILITY AND AGREE TO THE ABOVE TERMS.
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Makerspace Application

Participations, Release, and Medical Agreement