NCW STEM Day Registration Form

National Chemistry Week STEM Day Registration
Participant Information

Join us for STEM Demo Day on Saturday, October 18, 2025, from 10:00 AM to 12:00 PM in the Shuford Science Building on the campus of Catawba College.This year’s National Chemistry Week theme, The Hidden Life of Spices, comes alive through hands-on activities and exciting experiments for kids of all ages! Discover the science hiding in your spice rack while exploring the chemistry of flavor, color, and reactions. Safety glasses will be provided, but participants must wear closed-toe shoes (no Crocs or open-heeled shoes allowed). Don’t miss this chance to explore the wonders of science in a fun and interactive environment—where a dash of spice meets a spark of curiosity!
Participant's Name*

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Home Address

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Parent/Guardian Information
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Emergency Information
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Does the participant have any allergies, chronic illness, or medical conditions? If yes, please describe.
Is the participant prescribed an inhaler? If yes, please explain any instructions.
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Catawba College Natural Sciences during the selected camp. In exchange for the acceptance of said child’s candidacy by Catawba College Natural Sciences, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Catawba College and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against Catawba College. including all Professors and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all activities, including STEM activities. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death. I understand that Catawba College is not responsible for any accident or injury resulting from my child's participation in this event. Closed-toed shoes are required for participation and safety glasses will be provided.
Consent to Photography and Media Use:

I hereby give consent for my child’s photo/video to be used by [insert organization/institution name].I do NOT give consent for my child’s photo/video to be used by [insert organization/institution name].
Medical Release and Authorization

As Parent and/or Guardian of the named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to the Catawba College and its affiliates including Professors, etc., to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.
Consent to Photography and Media Use:

I hereby give consent for my child’s photo/video to be used by [insert organization/institution name].I do NOT give consent for my child’s photo/video to be used by [insert organization/institution name].
Minor Consent to Photography and Media Release Waiver

I, the undersigned, am the parent or legal guardian of the minor child named below, and I hereby give my permission for Catawba College and its representatives to photograph, film, or otherwise capture images and/or video of my child during participation in STEM Demo Day on October 26, 2024.I understand that these images or videos may be used for promotional, educational, or informational purposes, including but not limited to publications, social media, websites, or other media platforms. I agree that Catawba College shall have the right to use, reproduce, and distribute these images without further compensation, payment, or any other consideration to me or my child, and without further notice.I release and discharge Catawba College, its agents, and representatives from any and all claims, demands, and liabilities related to the use of these images, including any claims for libel or invasion of privacy. I understand that I may revoke this consent at any time by selecting "no" in the options below, but such revocation will not apply to materials already produced or in use.
Consent to Photography and Media Use:

I hereby give consent for my child’s photo/video to be used by [insert organization/institution name].I do NOT give consent for my child’s photo/video to be used by [insert organization/institution name].
Waiver of Compensation:

I acknowledge that no compensation or payment will be provided for the use of my child’s image or video.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
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National Chemistry Week STEM Day Registration

Participant Information

Minor Consent to Photography and Media Release Waiver