Kids' STEM Camp - Saturday, October 7
Presented by Madison High School Robotics Team
Location:  Madison High School (enter at door 11)
Date/time:  Saturday, October 7, 9am-2pm

Come spend the day with the Madison Robotics Team!  Campers will rotate through various STEM activities and games, and get a chance to see a demo of our AMAZING robot, Susan!  Take a tour through the Robotics room at Madison and see our laser cutter in action.  Pizza lunch will be provided. 

Questions?  email your questions to:   team@jmhsrobotics.org
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Student - First Name *
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Parent Name *
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Known Allergies (if allergies, include information on severity/medications): *
Known health/medical conditions we should be aware of, specifically, those that may limit physical ability.  Please note:  Madison Robotics is not authorized to administer medications.
I understand that the lunch option will be pizza.  If my child needs an alternative, I will send in a bagged lunch. *
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GENERAL RELEASE:  I hereby agree for myself and/or my child and our respective heirs, assigns and legal representatives, to indemnify, defend, and hold the James Madison High School Robotics Team and the
James Madison Robotics Booster Organization, Inc., and their collective members, officers, directors, board members, employees, volunteers, agents, independent contractors, and instructors (together, the “Robotics Team”) harmless from any and all claims and causes of action of any nature for any and all losses, expenses, personal injury or illness, including, but not limited to death. I further waive any and all claims or causes of action, which I and/or my child may now or hereafter have against the Robotics Team which may at any time arise directly or indirectly from my child’s participation in the program.  I further expressly understand and agree the foregoing indemnity, release and waiver is intended to be as broad and inclusive as permitted by the laws of the Commonwealth of Virginia and that if any portion thereof is held invalid, illegal or unenforceable, it is agreed that the balance shall, notwithstanding, continue in full force and effect.

ASSUMPTION OF RISK:  I, individually and/or on behalf of any minor child, expressly and specifically assume any and all risk of injury, illness, death, or property damage resulting from all activities participated in while at this event. I understand the risks involved and accept all of the risks.

MEDICAL RELEASE:  I, individually and/or on behalf of any minor child, further hereby release the Robotics Team from any claim whatsoever which may arise as a result of any first aid, treatment, or services or assistance provided to my child in connection with any injury that arises from activities at the event for which I am registering. I hereby give permission for emergency medical treatment to be administered as deemed appropriate by the Robotics Team.

INSURANCE:  I UNDERSTAND THAT I MUST HAVE MY OWN HEALTH INSURANCE TO COVER MY CHILD.  I understand that the Robotics Team does not carry insurance to cover injuries and losses that may befall my child. Further, I understand and agree that should medical attention be required, I and/or my insurance provider shall be responsible for all costs associated with such medical attention.

PHOTOGRAPHIC RELEASE:  I consent, on behalf of my minor child, to be photographed and to allow the Robotics Team to use of any photos of my minor child at its sole discretion, without compensation.

RULE ACKNOWLEDGEMENT:  I understand that myself, and my minor child, are required to observe and obey all rules and regulations governing the event I am registering for and failure to do so may result in me and/or my child’s expulsion from this event, without a refund. I further understand and agree that all fees paid hereunder are NONREFUNDABLE.
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Please make your $75 payment at the link above to complete your registration.  You will receive a confirmation once the payment is complete.
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