Release Form
My son/daughter(s), has my permission to participate in the STEMBoost Summer STEM Workshops of 2018 at Omei Academy.
I hereby agree to hold harmless the STEMBoost Board of Directors, officers, instructors, volunteers and Omei Academy owner and staff and/or their members with respect to any and all damages or expenses which may be incurred, suffered or required to be paid by reason of this activity before, during or after each workshop.
In addition, I hereby authorize STEMBoost to use, modify, reproduce, distribute photograph/videotape of my child for publicity and promotional purposes.
Below are the telephone numbers where I can be reached, both day and evening, during these date(s) should it be necessary to contact me in the event of an emergency.
I hereby agree to hold harmless the STEMBoost Board of Directors, officers, instructors, volunteers and Omei Academy owner and staff and/or their members with respect to any and all damages or expenses which may be incurred, suffered or required to be paid by reason of this activity before, during or after each workshop.
In addition, I hereby authorize STEMBoost to use, modify, reproduce, distribute photograph/videotape of my child for publicity and promotional purposes.
Below are the telephone numbers where I can be reached, both day and evening, during these date(s) should it be necessary to contact me in the event of an emergency.
By clicking "Submit", I am agreeing to the statement above and certify that this information is accurate.