STEM From Dance Event Registration

Welcome to the STEM From Dance Event registration form.

Join us for a day of exploring STEM and dance. Learn how you can use these two fields to understand the world, express yourself, and create something inspiring. 

This form includes parent/guardian waivers which must be completed and submitted in order to participate in the event.

Student Information



Provide a personal non-school email for the student. Each student must have a unique email address.

Provide a unique personal email for each student applying if you can (non-school email).


Student must be btw ages of 8-18 to participate in this program.

School Information


We gladly welcome girls of all backgrounds! 

Select all that apply.
Parent/Guardian Details







Tell us more about yourself:



Select all that apply.


Anything else?


Parent/Guardian Waivers

For the student to be allowed to participate, the following enrollment waiver must be completed by a parent or guardian.
ACKNOWLEDGMENTS AND AGREEMENTS OF STUDENT AND PARENT/GUARDIAN

I, Student and, if Student is under the age of 18, parent or legal guardian (“Parent/Guardian”) of the minor Student, for myself and on behalf of the Student, if applicable, acknowledge and agree as follows:

1. Conduct and Capability to Participate.  I acknowledge and agree that Student will follow direction from STEM from Dance staff and is to abide by all rules and regulations governing conduct during the program. 2. Photo/Video Consent. In consideration for the opportunity for Student to participate in the program and in connection with the programs, I give permission for STEM from Dance, including its owners, agents, volunteers, assistants, employees, contractors, guest artists, and faculty members (collectively, the “SFD Affiliates”) to photograph, video, film, and interview Student and to use Student’s statements, image, voice, likeness, bio, and/or story in any format, including photos, film, video, audio, print or electronic, and grant to STEM from Dance the perpetual and worldwide right and license to use such materials in their sole discretion to promote, advertise, and provide information concerning STEM from Dance’s programs, events, and operations.  I understand that the foregoing license includes use of the materials on print and electronic media and that these materials may be made available to students and parents/guardians as requested. I acknowledge that neither the Student nor II will not receive any compensation for using such materials and that I have been fully advised of STEM from Dance’s intended use of the materials and understand the same. 3. Release and Discharge. I understand that by signing this form, I hereby release and discharge STEM From Dance, the SFD Affiliates, and/or other students (the “Released Parties”) from any and all claims of injury or loss which Student may suffer, arising in whole or in part from Student’s enrollment or participation in the program, including but not limited to any injury, accident, illness, loss or damage to property occurring during the program. I acknowledge that I will not seek to have STEM From Dance held liable in the event that any accident, injury, loss of property, or any other circumstance or incident occurs during or as a result of my child’s participation in the program. 4. Assumption of Risks.  I understand that participating in the program activities involves certain risk and that injuries, death, property damage or other harm could occur to the Student and others. I acknowledge and expressly assume all risks and dangers associated with all program activities, known or unknown, and inherent or otherwise whether the risks and dangers were caused in whole or in part by the negligence of the Released Parties.  I understand that although Student will be supervised by STEM From Dance faculty and staff, I do assume the risk in Student’s participation in the program. 5. Waiver of Claims. I further hereby voluntarily agree to waive any and all claims against any of the Released Parties for any such damage, loss, injury, or any other circumstance or incident during or because of Student’s participation in the program whether it was caused in whole or in part by the negligence of the Released Parties. 6. Indemnification for Injury Caused by Student.  I acknowledge that I, as Parent/Guardian of Student, may be held liable and responsible for any injury or death to another person or injury to property of another caused by Student, as required by law.  I hereby agree to indemnify, meaning to defend, and to satisfy by payment or reimbursement, including costs and attorney’s fees, and hold harmless the Released Parties with respect to any claims of injury, death or other loss or damage to person or property suffered by any person arising in whole or in part from the conduct of Student while enrolled or participating in the program. 7. General Provisions. I understand that this agreement will be binding to the fullest extent permitted by law. If any provision of this agreement is found to be illegal, invalid or unenforceable, the remaining terms will be effective.

SECTION TO BE COMPLETED BY PARENT/GUARDIAN

I acknowledge that I have carefully read this document, waiver, and release, and understand the information therein.  My signature on this form shall constitute an informed and knowing waiver as required by law. I agree to each of the terms and acknowledgments above and agree to permit my child to participate in the program described above.
ENROLLMENT E-SIGNATURE



Informed Consent and Liability Waiver Release for Participation in the Office for Community Engagement and Inclusion On-Campus Activity

I agree and consent to the following for my minor child:

My minor child will be attending the STEM from Dance Pop-Up (“Activity”) conducted on February 22, 2025 from 8am-1pm, at 3009 Broadway, NY NY 10027. I am fully aware of the risks and hazards involved in my minor child participating in the Activity, including those related to COVID-19. For this Activity, participants will be on the Barnard College campus interacting with members of the college community. I am aware that some attendees may not be vaccinated. I am aware that it is possible for my minor child to be exposed to and/or contract COVID-19 in connection with my attendance at and participation in the Activity, including my minor child's transportation to and from the location of the Activity – even if my minor child is fully vaccinated. I will ensure my minor child adheres to the College’s policies and follows local, state and federal requirements and guidelines as they relate to COVID-19.

I am responsible for my minor child's transportation to and from the Activity.

I assume responsibility for all risk or theft, loss or damage of my minor child's personal property which occurs at any time arising out of my minor child's participation in the Activity.

To the extent permitted by law, and in consideration for my minor child being allowed to participate in the Activity, I hereby save, hold harmless, discharge and release Barnard College, its current and former Trustees, officers, agents, employees, and representatives from all claims, demands and causes of action (including medical costs and expenses) which I (as the parent or legal guardian of the minor child), my heirs, representatives, executors, administrators or any other persons acting on my behalf or on behalf of my estate. I agree to indemnify and hold harmless, waive and covenant not to sue Barnard College, its officers, Trustees, agents, employees and representatives from liability for the personal injury of any person(s) or damage to property that may result from my minor child’s negligent or intentional act or omission while participating in the Activity.

By participating in the Activity, I consent for my minor child to be photographed or otherwise recorded by the College or its designee for news, promotional purposes, or other College uses, including but not limited to publication of such recordings on its website and social media.

Medical Insurance: I acknowledge and accept that participating in the Activity may expose my minor child to hazards and risks and that Barnard College cannot control these risks. I acknowledge there may be physically strenuous activities and certify that my minor child is fit and capable of such participation. I am responsible for understanding my minor child’s own physical limitations and operating within them at all times and I assume full responsibility for any risks, injuries or damage known or unknown which my minor child may incur as a result of participating in the Activity. 

I understand that Barnard College is not responsible for any medical expenses associated with any personal injury my child may sustain and understand that Barnard College does not provide medical insurance for me and my minor child. I certify that my minor child is covered by adequate insurance to cover any personal injury which they may sustain while participating in the Activity at Barnard College. I hereby authorize the faculty and staff of Barnard College to act for me according to their best judgment in any emergency requiring medical attention for my minor child. I authorize and give consent for Barnard College to administer general first aid for any minor injuries or illnesses experienced by my minor child.

I have read the above waiver and release of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above.

I understand that this Agreement is to be as broad and inclusive as is permitted by the laws of the State of New York, and that if any portion of this Agreement is held invalid, the remaining terms shall continue in full force and effect.
NEW YORK STATE WAIVER E-SIGNATURE
I acknowledge that I have carefully read this document, waiver, and release, and understand the information therein. My signature on this form shall constitute an informed and knowing waiver as required by law. I agree to each of the terms and acknowledgments above and agree to permit my child to participate in the program described above.


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