Operation STEM Permission FormΔ Newsletter First NameLast NameSchool NameAgeLegal Guardian First NameGuardian Phone/MobileLegal Guardian Last NameEmailEmergency Contact First NameEmergency Contact Last NameEmergency Contact Phone/MobileDietary Requirements and/or Food Allergies Lactose Intolerant Gluten Free Halal Kosher Vegan Vegetarian None Other:• Are there any allergies (outside of those listed above) STEMforGIRLS Coordinators should be aware of?Are there any medical or health-related needs STEMforGIRLS Coordinators should be aware of to support the participant’s well-being during the program?If you selected other, please describe.Shirt Size (Adult Sizes)– Select –XSSMLXLXXLPlease share any additional information STEMforGIRLS Coordinators should know to best support the participant during the program.No commentsParticipant Rules • Cell phone use is prohibited during STEMforGIRLS programming unless a STEMforGIRLS coordinator advises.• Cameras are not permitted unless advised by STEMforGIRLS.• 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.• Participants will be respectful of the rules outlined by worksite staff.• Participants are expected to be on time and always advise their school’s educators of their whereabouts. Please review the STEMforGIRLS Code of Conduct for general behavioural expectations.Media ReleaseI permit STEMforGIRLS to use pictures or videos for educational and promotional purposes. Yes NoDemographic InformationDemographic Information The following questions help us ensure that our programs are inclusive. These responses are confidential and optional. We recognize that this is not exhaustive. We encourage you to choose the best option(s) for you. If you would like to see a new tag included to share additional information about your identity and background, please email us at stemforgirls@equiforce.ca. Do you identify as: (Select all that apply) An Indigenous person An immigrant or refugee A member of a racialized group As someone with a visible or invisible disability As neurodiverse None of the above Prefer not to sayGuardian 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 #NextGenInSTEM Camp. I understand the participant will be involved in the program and all related activities, which may include travel to and from project activities. All medical and emergency contact information for the participant is included within this form, and I will provide the Program Coordinator with any necessary medications during event days. I have discussed the above participant rules and general behaviour expectations in the Code of Conduct with the participant. 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 participation in STEMforGIRLS Operation STEM event.Feedback ParticipationAt times, feedback surveys are requested to help us improve and share the impact of our programs. Providing feedback is always optional; it is never required to participate in the program. If you choose to complete feedback surveys, you are consenting to STEMforGIRLS’ use of survey data for program development, reporting, and promotional purposes. Responses will remain confidential and anonymized. I understandGuardian 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 amanda@equiforce.ca to discuss how we can best accommodate you.Submit Permission Form
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