Attendee *

First Name

Last Name

Gender Attendee *

Female

Male

Other

Prefer not to say

Do you have any dietary preference? *

Vegan

Vegetarian

None

Food allergies? *

Lactose

Gluten

Nuts/seeds

Shellfish/seafood

Soy

None of the above

How severe is this allergy? *

Mild

Not severe, but requiring treatment

Severe, requiring immediate treatment

Do you or your child carry an EpiPen (or equal alternative)? *

No

Yes, for the above mentioned food allergy/intolerance

Yes, for a different allergy/intolerance

Do you already know which STEM field(s) you’re most interested in? *

Science

Technology

Engineering

Mathematics

No, but I'm excited to find out!

Parent/Guardian/Other name *

First Name

Last Name

Children under the age of 18 need to have the waiver and health questionnaire filled and signed by an adult. *

By checking this box, I confirm that I am either a responsible adult aged 18 years or older with a child under the age of 18 participating in the event or an adult aged 18 years or older

In case your child has a medical emergency, do you consent for a trained medical professional to treat them in their best interest? *

Yes, I consent

No, I do not consent

Does your child have and carry (escape) treatment in the case of emergency?* *

Yes

No

RELEASE OF LIABILITY WAIVER - PLEASE READ CAREFULLY AND AGREE *

DEFINITION OF TERMS USED IN THIS WAIVER ● We/ Us/ Our/ TSE: The STEM Embassy, affiliates, representatives, partners, officers, employees, and/or volunteers ● UA: The University of Aruba, affiliates, and or employees, the venue and location of the STEM camp event. ● You/ I/ My/ Participants: Person signing this waiver for themself or a minor dependent they are responsible for or any participant partaking in activity from start to finish organized by TSE. THIS WAIVER IS VALID FOR JULY 26, 27, 28 and 29: KI' TA BO STEM? ARUBA 2023.

By checking this box, I understand and agree to these terms.

ASSUMPTION OF RISK ASSOCIATED WITH WORKSHOPS *

I understand and agree with the following information presented clearly below regarding the hazards, risks, and possible endangerments associated with the STEM workshops. Additionally, I am completely aware that the following list of possible hazards and risks is not absolute, and that there are possible associated risks with workshop participation. There is always a risk of possible injury during the workshops including but not limited to: - Injury due to wrongful consumption of allergenic food (which was not assigned directly to the participant). - Injury with specialized tools, glassware, or equipment - Injury from acts of nature/ unforeseen weather conditions - Injury from negligence including my own or by other participants - Injury from heat-related illness

By checking this box, I understand and agree to assume the risk associated with STEM workshops

PHOTO RELEASE AGREEMENT *

I understand and agree that my permission is given for the possibility that my likeness in a photograph, video, or any other digital media may appear in any or all of TSE publications, including web-based publications without prior notification, payment, or other consideration. Please sign accordingly and your likeness will not be used if you do not agree.

By checking this box, I understand, agree, and give permission to have my likeness photographed.

DECLARATION OF HEALTH *

I hereby proclaim I am physically able to participate in the selected activity with TSE. I have not been diagnosed by an official medical doctor with any illness that would restrict me. I will not partake in any activity with TSE against medical advice. (If there is something TSE team needs to be aware of, please email us at info@thestemembassy.com)

By checking this box, I understand and agree to follow any medical guidelines as indicated by any professional