2024-2025 Registration - Young STEAMers at Learning Bee 
Sign in to Google to save your progress. Learn more
Email *
Parent/Legal Guardian First and Last Name 
Parent/Legal Guardian Phone Number
*
In the event of an emergency, please contact the following person(s) in the order presented (Contact Name, Relationship, Contact Telephone)
*
Student First Name, Last Name and Grade (add all participating students ) *
Select Sessions:
Lessons held weekly on Mondays in small groups (max of 12 kids)
K-2 grade 3:30 - 4:30 pm 3-5 grade 4:40 - 5:40 pm

Session I - Technology - What’s Inside? Anatomy of Everyday items
Sept 9, 16, 23, 30, Oct 7, 14, 21, 28, Nov 4, 18, Dec 2, 9, 16 ( $475/13 lessons*)

Session II - Build Together (the engineering process)
Jan 6, 13, 27, Feb 3, 10, 24, March 3, 10, 17, 24 ($375/10 lessons*)

Session III - Crazy Chemistry
March 31, April 7, 14, 28, May 5, 12, 19 ($275/7 lessons*)
*
Required
PARENT'S APPROVAL AND PARTICIPANT WAIVER
The undersigned parent(s) or guardian(s) assume all risks in connection with the participation of their child in Young STEAMers activities. I attest and verify that my child listed above is physically fit and able to participate in Young STEAMers activities. Further, I acknowledge that it is my responsibility to understand any inherent risks associated with Young STEAMers activities. I do hereby certify that to the best of my knowledge and belief all individuals named above are in good health. In the event that I, or other parent / guardian, cannot be reached in an emergency, I hereby give permission to secure proper medical and/or dental treatment for my child. It is further understood that the undersigned will assume full responsibility for any such action, including payment of costs.

I / we, as parent(s) or guardian(s) of the minor(s), do hereby, for my child, myself, my heirs, executors and administrators, release and forever discharge and hold harmless Young STEAMers organization and all officers, directors, employees, agents and volunteers of the organizations, acting officially or otherwise, from any and all claims, demands, actions or causes of action which in anyway arise from the participation of any individuals listed above in Young STEAMers activities. By agreeing below, I confirm that I have carefully read and fully understand its contents. I am aware that this is a release of liability and I have agreed to it of my own free will.
WAIVER AND RELEASE OF LIABILITY
In consideration of the risk of injury while participating in the Young STEAMers Classes  (the "Activity"), and as consideration for the right to participate in the Activity, I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives, knowingly and voluntarily enter into this waiver and release of liability and hereby waive any and all rights, claims or causes of action of any kind whatsoever arising out of my participation in the Activity, and do hereby release and forever discharge Young STEAMers, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, for any physical or psychological injury, including but not limited to illness, paralysis, death, damages, economical or emotional loss, that I may suffer as a direct result of my participation in the aforementioned Activity, including traveling to and from an event related to this Activity.
I am voluntarily participating in the aforementioned Activity and I am participating in the Activity entirely at my own risk. I am aware of the risks associated with traveling to and from as well as participating in this Activity, which may include, but are not limited to, physical or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis), economic or emotional loss, and death. I understand that these injuries or outcomes may arise from my own or others' negligence, conditions related to travel, or the condition of the Activity location(s). Nonetheless, I assume all related risks, both known or unknown to me, of my participation in this Activity, including travel to, from and during this Activity.
I agree to indemnify and hold harmless Young STEAMers against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney's fees and any related costs, if litigation arises pursuant to any claims made by me or by anyone else acting on my behalf. If Young STEAMers incurs any of these types of expenses, I agree to reimburse Young STEAMers. I acknowledge that Young STEAMers and their directors, officers, volunteers, representatives and agents are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Young STEAMers. I acknowledge that this Activity may involve a test of a person's physical and mental limits and may carry with it the potential for death, serious injury, and property loss. The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, lack of hydration, condition of participants, equipment, vehicular traffic and actions of others, including but not limited to, participants, volunteers, spectators, coaches, event officials and event monitors, and/or producers of the event. I acknowledge that I have carefully read this "waiver and release" and fully understand that it is a release of liability. I expressly agree to release and discharge Young STEAMers and all of its affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, from any and all claims or causes of action and I agree to voluntarily give up or waive any right that I otherwise have to bring a legal action against Young STEAMers for personal injury or property damage. To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence on the part of Young STEAMers, its agents, and employees. In the event that I should require medical care or treatment, I agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance. In the event that any damage to equipment or facilities occurs as a result of my or my family's willful actions, neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any actions of neglect or recklessness.
This Agreement was entered into at arm's-length, without duress or coercion, and is to be interpreted as an agreement between two parties of equal bargaining strength. Both the Participant, (name above), and Young STEAMers agree that this Agreement is clear and unambiguous as to its terms, and that no other evidence will be used or admitted to alter or explain the terms of this Agreement, but that it will be interpreted based on the language in accordance with the purposes for which it is entered into. In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect, so long as the clause severed does not affect the intent of the parties. If a court should find that any provision of this agreement to be invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed and enforced as so limited.
PAYMENT CONDITIONS
  • Payment for this class is due by the first day of class. 
  • By registering for class, you are agreeing to receive text reminders if your payment is overdue.
  • Payment may be made in three ways: 1)  By credit card through the invoice link sent after your registration (includes a 2.99% credit card processing fee). 2) By Zelle to corporate@youngsteamers.org 3) By check made out to "Young STEAMers" and delivered to The Learning Bee.
I confirm that I have carefully read and fully understand that this is a release of liability and I have agreed to it of my own free will.
*
Required
Signature (Enter full name)
*
Date *
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Orna Kretchmer The Art in Science.

Does this form look suspicious? Report