STEAMposium 2025

Registration Form April 5, 2025 for grades 4-12

Check-in starts at 8:30 (Parents are required to check the student in)

Duration 9:00am - 12:30pm

Student's First Name

Student's Last Name

Student's Email

(Use parent/guardian cell Student's Cell If student does not have a cell number)

Students Cell If student does not have a cell number

Students School

Grade

How did you hear about this event? School, Social, Media, Flyer, Word of Mouth, Other:

How did you hear about this event?

All student attendees will be provided free lunch. Students with food sensitives (allergies, gluten free, etc should provide their own lunch. Select one: pizza and salad (no options) & continental breakfast or I will provide my own lunch

Lunch Option

The following questions must be completed by a Parent/Guardian.

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardians Email address

example@example.com

(This number will only be used in case of an emergency during the event)

Parent/Guardians Cell This number will only be used in case of an emergency during the event

Parent/Guardian Media Release

I hereby give permission for the use of photographs/videos of my child/student's likeness in publications and for promotional purposes. (Type YES or NO)

Parent/Guardian Medical Release.

I hereby give permission for my child/student to receive emergency medical (Type YES or NO)

The undersigned does hereby release, hold harmless, covenant not to sue and forever discharges the 100 Black Men of Greater Huntsville (AL), Greater Huntsville (AL), Chapter of The Links, Incorporated, National Society of Black Engineers (NSBE) Professionals North Alabama Chapter, and National Coalition of 100 Black Women (Huntsville), sponsors or promoters of this event, and any personnel assisting with the organization of this event of any and from all claims, demands, rights and causes of action of whatever kind or nature including, but not limited to, negligence arising from and by reason of any and all known and unknown, foreseen and unforeseen bodily and physical injuries, damages to property, and the consequences thereof, including death, resulting from any participation in or in anyway connected with this event. I understand that this Release, Covenant Not to Sue and Assumption of Risk shall become effective April 5, 2025. By signing this document, I hereby acknowledge that I have read the above carefully before signing and agree to comply with all the above

I understand that this Release/Covenant Not to Sue and Assumption of Risk shall become effective April 5, 2025. By signing this document, I hereby acknowledge that I have read the above carefully before signing and agree to comply with all the above.

ParentGuardian Signature

Date

STEAMposium 2025

EMPOWERING YOUTH SCIENCE TECHNOLOGY ENGINEERING ART MATH