Participant Release Waiver

STEAM ICAC 2025 Registration

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Participant Name

First

Last

Participant Personal Email

Confirm Email

Participant Phone Number

Participant Age

Participant School Name

STEAM ICAC Ticket Order Number

If you have paid on school cash online as you are a part of a chapter, please state your school name.

Are you a part of a school chapter?

Parent/Guardian Name

First

Last

Parent/Guardian Email

Confirm Email

Parent/Guardian Phone Number

Emergency Contact Name

First

Last

Emergency Contact Phone Number

Emergency Contact Email

Confirm Email

Event

Astronomy
Engineering
Life Sciences

Team Member 1 Name (If applicable)

First

Last

Team Member 1 Email (If applicable)

Team Member 2 Name (If applicable)

First

Last

Team Member 2 Email (If applicable)

Team Member 3 Name (If applicable)

First

Last

Team Member 3 Email (If applicable)

Notice

I understand that each team member must have an admissions ticket to their name and have filled out the “STEAM ICAC 2025 Registration” form to be admitted to STEAM ICAC. I also acknowledge that all tickets are non-refundable.

Minors must get the boxes below ticked by their legal parent/guardian.

I am the legal parent/guardian of the participating minor. I have read and agree to the ACCIDENT WAIVER, RELEASE OF LIABILITY AND MEDIA RELEASE TERMS below. I understand that ticking this box will constitute as my legal signature.

ACCIDENT WAIVER, RELEASE OF LIABILITY AND MEDIA RELEASE FORM

Event: STEAM ICAC 2025

STEAM ICAC 2025 is a conference that will include hands-on workshops involving the use of various materials and equipment. Items such as food, prizes, etc., may be distributed. STEAM IC is only the event host and is not responsible for the participants’ transportation or any other necessities.

I AM THE LEGAL PARENT/GUARDIAN OF THE PARTICIPATING MINOR AND I HEREBY ASSUME ALL OF THE RISKS OF THE CHILD’S PARTICIPATION IN THIS EVENT, and waive, release and discharge STEAM IC, and their directors, board members, officers, employees, volunteers, agents, representatives or assigns and the event sponsors, from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my or the child’s death, disability, personal injury, property damage, property theft, or actions of any kind which may occur to them as a result of participation in the above-named event. I agree to indemnify, hold harmless, and promise not to sue the entities or persons mentioned above for any and all liabilities or claims made as a result of participation in this activity or event, whether caused by the negligence of those released or otherwise.

This accident waiver and release of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

I authorize STEAM IC, its partners, agents, representatives, assigns, successors in interest and licensees, to photograph, audiotape, and/or videotape the child and grant the Organization and its partners the irrevocable right to use their photograph, audio recording, video recording, or any reproduction or modification thereof (the “Photograph,” “Audio,” and/or “Video”), in any manner or medium throughout the world an unlimited number of times in perpetuity in advertising, trade, promotion, exhibition, or any other lawful purpose.

I understand that I will not receive any monetary compensation for the permissions I am granting herein. I hereby waive any right of inspection of approval of the uses to which the Organization may put the Photograph, Audio, and/or Video.

I acknowledge the Organization will rely on this permission and hereby release and discharge the Organization from any and all claims and demands arising out of or in connection with the Photograph or the exercise of the permissions granted here, including any or all claims for libel, invasion of privacy, or emotional distress. I understand that I cannot withdraw my consent after I sign this form and that this consent and release is binding on me and my heirs, legal representatives and assigns.

I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND AGREE TO IT OF MY OWN FREE WILL.

Information Consent

My and/or my child’s name and email address may be shared with STEAM IC partners for promotional purposes