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Permission form 2019-2020
This BucksGirls Who Code Permission Form must be completed by Parent or legal guardian. This Permission Form is good for one entire school year from September 2019 through August 2020. This form must be completed by Parent or Legal Guardian. If Parent or Guardian wishes to attend, they may register on eventbrite form as a volunteer and must get proper documentation.
Email address *
Enter Child's complete Name *
Your answer
Enter Child's Grade *
Enter Child's School (if child is homeschooled, please indicate that) *
Your answer
Enter Parents/Legal Guardian email address and telephone number
Your answer
My child, who name is listed above, has permission to participate in STEMgirlz/GirlsWhoCode programs during the 2018-2019 school year. *
Required
Indemnity and Waiver of Claim: I acknowledge that as a condition of the Student participating in any of the programs or activities, I agree to indemnify and hold harmless STEMgirlz, GirlWhoCode, its volunteers, and the owners of the place where the program/activity is being held, from any liability arising out of the above mentioned program or activity. *
Required
Please include email address and phone contact number of designated adult. (this information will be used to contact adult in case of emergency during the event) *
Your answer
Photographic Image Use: I do give permission for photos or videos to be posted on STEMgirlz/GirlsWhoCode website, approved partner websites, or for press related purposes. No last names will be used on the website. *
Required
Please type in your First and Last Name. I understand that typing my name in this box constitutes a legal signature of Parent or Legal Guardian confirming that I acknowledge and agree to the above Terms of Acceptance. *
Your answer
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