STEMforGIRLS In-School Session Consent Form

In-School Student Permission Form (#35)

First Name

Last Name

School Name

Grade

Legal Guardian First Name

Legal Guardian Last Name

Participant Rules

• Cell phone use is prohibited during STEMforGIRLS programming unless a STEMforGIRLS coordinator advises.
• Foul language will not be tolerated.
• Visitors and guests are not permitted to visit, view, or attend STEMforGIRLS programming; this includes activities that may take place in a public venue.
• Smoking, alcohol, or other drugs will not be tolerated.

Please review the STEMforGIRLS Code of Conduct for general behavioural expectations.

Media Release

I permit STEMforGIRLS to use pictures or videos for educational and promotional purposes.

Yes

Guardian Consent

By submitting this online permission form, I confirm that:

I am permitting the applicant, of whom I am the legal guardian, to participate in the upcoming STEMforGIRLS in-school session.

I understand that participation in this activity is voluntary. The purpose of the activity will be explained to your child, and even if you provide consent, your child can still choose not to take part.

I understand that the applicant may be asked to complete an anonymous survey, for the purposes of gaining feedback on the programming provided. If they do participate, they can skip any questions or stop at any time. They will also have the opportunity to ask questions before, during, or after the activity. Answers or comments from this survey may be used for promotional purposes or in future reporting and funding applications.

I have discussed the above participant rules and general behaviour expectations in the Code of Conduct with the applicant. They understand that they must behave responsibly and follow all instructions explained by the supervisors during the program.

I have reviewed the terms of service and privacy policy.

I release Equiforce (formerly WRDC) – Educational Resource Centre and its associates from any claim for damages or other harm suffered in connection with, or directly arising from, the applicant’s participation in STEMforGIRLS.

Guardian Signature

Sign Here

A copy of this form, including participant rules, will be automatically sent to your email. Please review them with the participant prior to the event.

If you have any accessibility needs or requests that would support your students’ participation, please email Amanda Klein at aklein@wrdc.ca to discuss how we can best accommodate you.

STEMforGIRLS In-School Session Consent Form

Participant Rules

Media Release

Guardian Consent

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