STEM Club Regional Event Consent Form
Participant Information
Student Name
Date of Birth
School Name
Grade
Parent/Guardian Information
Parent/Guardian Name
Relationship
Phone
Email
Medical Information
Allergies or Medical Conditions
Medications
Emergency Contact
Name
Phone
Consent
I give permission for my child to participate in the STEM Club Regional Event.
I consent to photos or videos of my child being taken for event promotion.
In case of emergency, I authorize necessary medical treatment for my child.
Parent/Guardian Signature
Date