2026 PF STEAM Leadership Conference Mandatory Medical Release Form
  • 2026 Project Fibonacci® STEAM Leadership Conference Mandatory Medical Release Form

  • Date of Birth*
     - -
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Allergies/Special Conditions:
    Please specify any other health concerns, physical activity restrictions, and/or any other information you want the Project Fibonacci® staff and chaperones to be aware of on behalf of your child's welfare. 

  • Medications:
    You must bring your child's current medication in the original packaging, labeled with your child's full name, date of birth and dosing information. Project Fibonacci® Event Medics will inventory and collect all medications/prescriptions - including over the counter medication, vitamins, and supplements, at registration. For safety reasons, STEAM Scholars are never allowed to keep any medications (prescription or OTC), vitamins or supplements in their hotel room or on their person except epi-pens or inhalers, as medically necessary regardless of age. Medication/prescriptions will be locked at the Event Medics station (locations will be made known to you). As needed, participants will request their medication from the Event Medic for self-administration. Any need for assistance (e.g., injection) will be referred to the closest medical facility.

  • Rows
  • Parent/Guardian Acknowledgement: I understand that I will be notified in case of serious injury or illness. However, in the event I cannot be reached, I hereby give permission for my child named above to be medically treated by a physician or medical facility as appropriate. I hereby give permission for the event medics to inventory, collect, keep all medications and supervise my child's self-administration for the duration of the event, as described.

  • Student Participants (18+): I give my permission to be medically treated by a physician or medical facility as appropriate, in the event of an emergency or illness.

  • Should be Empty: