Quantum Leaps 2022 - Registration form

2022 Quantum Leaps: Girls in STEAM and Leadership Conference

Tuesday, March 8, 2022 from 3:30 to 8pm PST - Virtual Event
Kootenay Association for Science and Technology (KAST) invites you to register for Quantum Leaps!

Quantum Leaps is a virtual Girls STEAM & Leadership conference for ALL Kootenay & Boundary girls in grades 8 to 12. Taking place on International Women’s Day, the 2022 event will aim to inspire, educate, and introduce participants to a variety of STEAM-focused education and career pathways while emphasizing the importance of women’s leadership and an over-all conference theme of Health.

We’re pros at dreaming big, building connections and linking you with professional women from across Canada who pursued STEAM education and careers, and want to share their stories with YOU!
In this registration form, you will find:

1. Participant information

2. Choose Your Own Adventure (conference program)

3. Virtual software information & consent form

**This registration form needs to be filled out by a parent/legal guardian**
1. Participant information
Is the participant a*

StudentTeacher
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

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

Area CodePhone Number
School*
Grade:*
Age*
2. Community Outreach

Please let us know how we reached you.
How did you hear about Quantum Leaps

Social Media FBSocial Media IGSocial Media TwitterKAST/GLOWS NewsletterNewspaperPosterSchoolWord of Mouth
3. Choose Your Own Adventure

If you haven't yet, take a look at the Quantum Leaps program!

Then please select the activities you would like to attend during Quantum Leaps 2022.
4:00PM

KEYNOTE: Shelina Musaji The Possibilities of Practicing Medicine
4:40PM

Breakout 1: Michelle Spencer: Statistics to StoriesBreakout 2: Jennifer Sun: Pathway to a PHD: Biomedical Engineering
5:20PM

Breakout 3: Cindy Lazenby: Pathways to Health EntrepreneurshipBreakout 4: Aura Romay Health: How Video Games help us channel our emotions, skills and habits
6:00PM

PANEL: Takai Larsen + Rural Pre-Medicine Program Students + Alumni (will take place in Keynote Room)
6:40PM

Breakout 5: Jae Euteneier: Online Harassment and YouBreakout 6: Emily Lankhorst: From Music to Medical: It's Okay if You Don't Know!
7:20PM

Breakout 7: Aura Romay: Scratch Coding Workshop - Create your own shooter and destroy invasive germs.Breakout 8: Gabriele Herle + Nicole Wiet Health, Safety + the Trades - A Lifelong Journey
4. Virtual Software & Consent Form
About the web platform: gather.town

Gather.town is a free web platform that allows participants to interact with one another in a similar way as we would in person. No sign-up is required.

Participants will be assigned an avatar that they can move around the virtual space to access conferences, workshops.

The platform will ask permission to activate the participant's microphone and camera.

More information at: https://gather.town/

Consent Form:

I hereby authorize that my child, as listed in the previous page, has my permission to participate in the Quantum Leaps conference, which is hosted by the Kootenay Association for Science & Technology (KAST).

By signing this consent:

I understand that Quantum Leaps is not a school supervised event, as it takes place after school hours.

I understand that KAST will take screenshots for marketing purposes (KAST will blurr out names of the participants) and will record the speaker sessions and workshops in order to send the recording to the participants after the event.

KAST and event organizers are taking steps to provide a safe and productive learning environment by:
- Adding a password to secure access to the event platform
- Promoting respect and good manners when addressing another participant
- Having volunteers/organizers in all rooms to moderate the chat and general conversations
- Giving warnings to participants who do not respect the rules of good conduct and/or banning participants from the virtual platform.
However, I acknowledge, understand, recognize and fully accept that activities at the conferences or workshops will include interactions using their cameras, microphones, chats (private messages and general messages)
Gather.town require participants to be 13 years old and older. If a participant is not yet 13 years old, we will ask that a parent/guardian attend the event with the participant.
Are you 13 years old or over?*

YesNo
If no, I (Parent/guardian) take responsibility to supervise my child/Learner during the event Quantum Leaps 2022.*

I agree
Name of Parent/Legal Guardian:*

First NameLast Name
Relationship to the participant:*
Email*
example@example.com
Phone Number*

Area CodePhone Number
*

By clicking on this button, I acknowledge having read, understood and voluntarily agreed to the entirety of this consent form. I declare that I am the parent or legal guardian of the participant.
Should be Empty:

2022 Quantum Leaps: Girls in STEAM and Leadership Conference