STEM event youth registration

STEM Event Youth Registration

Register your student for STEM event. Please complete all required fields to ensure proper enrollment and safety.
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Date
Start Time
Please select the city for the STEM event you wish to register for.
STEM event program interested in New Britain
STEM event program interested in Portland
STEM event program interested in Minneapolis
STEM event program interested in
General Reminder 6 days before

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Logistics Reminder 3 days before

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Post event 2 days after

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Day before reminder

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Event Address
Day of the event
Parent/Guardian/Group Coordinator Full Name

First NameLast Name
Parent/Guardian/Coordinator Email
example@example.com
Parent/Guardian/Coordinator Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name (if different from parent/guardian)

First NameLast Name
Are you registering as a Family or a Group?
(-****Individual or Family: Select this if you are a parent or guardian registering 1–5 students from your own household. -****Group (School/Club): Select this if you are a teacher, coach, or coordinator registering a school, club, or large organization.)
For Group/School registrations, please upload an Excel sheet containing the full list of students. You do not need to fill out the individual student rows below. To register your group, please upload an Excel file (** .xlsx or .csv**) containing your student roster. To ensure your registration is processed correctly, please ensure your file includes the columns shown in the image below (First Name, Last Name, Grade, Age, T-shirt Size, Gender, and Lunch Status).

Download the template here - Template
Student File Upload (Please read instructions above)

Cancelof
Please provide details for every student attending. Click Add Row to register another
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Media Consent and Release:

I acknowledge that photographs, videos, audio recordings, or other media of my child may be taken during STEM programs or events. I understand and agree that: * Media may be used without compensation to me or my child. * The organization may edit, alter, or modify the media as necessary. * Media may be combined with other images, text, and graphics, and may be used in any medium, including digital and print formats. The organization retains all ownership rights to the media.
Photo/Video Consent
T-Shirt Size
Allergies / Medical Concerns (please specify)
How did you hear about STEM events?
Consent to Participate:

I, the undersigned parent or guardian, grant permission for my child to participate in STEM programs, including all related activities, workshops, and events. I acknowledge that: * Participation may involve hands-on activities that require interaction with materials and substances, which could pose risks such as minor injuries (e.g., scrapes, bruises, or allergic reactions). * All reasonable precautions will be taken to ensure the safety of participants. * I am responsible for notifying STEM event staff of any specific needs, allergies, or medical conditions that may affect my child’s participation. * STEM event and its representatives are not liable for unforeseen incidents beyond their control during participation.
Participant Gender
Participant Ethnic Background
Does the student receive free or reduced lunch?
Should be Empty:

STEM Event Youth Registration

Media Consent and Release:

Consent to Participate: