Karelo.com - Register - Science ALIVE SFU

Event:

Invent the Future Program 2024

Last Name:

(*)

Apartment:

Postal Code:

(*)

Country:

(*)

Business Phone:

Email:

(*)

Participant First Name:

(*)

Preferred Name:

Grade Completed as of June 2024:

(*)

PROGRAMS

IF-W8:

Week 8 (All Girls): Aug 19-23, Gr. 7-9, Cdn$ 265.00

IF-W8-C:

YES: I confirm that I'm aware of this participation criteria. (*)

Pre-Care and Post-Care:
Only those weeks corresponding to your program selection above will show up.

Week 8 (Aug 19-23):

Promo Code:

Does the participant have experiences with the coding languages below?

Please rate the participant’s coding skills

Please rate the participant’s interest in coding.

Please rate the participant’s interest in artificial intelligence

Sign Out Consent:

Self Sign Out, no adult signature required Guardian Sign Out (*)

Guardian Release *Provide full names as listed on Government Issued ID

Authorized Person 2:

Authorized Person 4:

Primary Parent / Guardian Information

Primary Parent/Guardian Last Name:

(*)

Relationship:

(*)

Primary parent/guardian Phone Number:

(*) Format: ###-###-####

Secondary Parent/Guardian First Name:

What is the relationship between the participant and this adult (e.g. mother)?

Secondary parent/guardian Email:

Format: name@domain.com

Please check the box to confirm that you have reviewed the program details and items under the “Things to Know before Registering” section, which includes our refund and cancellation policies.

If possible, provide a contact that is different from the primary and secondary parent/guardian in the event we cannot reach both contacts.

What is the relationship between the participant and this adult (e.g. mother)?

Emergency Contact Phone:

Format: ###-###-####

Participant's Personal Health Number:

On travel insurance (*)

Birthdate:

(*)

Please indicate any medical/physical or behavioural needs that may affect your child’s participation in the program. This information will help us provide the necessary support to ensure a safe and inclusive learning environment.

Medical Services Waiver:

I agree to allow SFU staff to provide or cause to be provided to me or my child such medical services as SFU or medical personnel consider appropriate.

YES: I have read, understand, and agree to be bound by the above terms. (*)

Photo Waiver:

We would like to seek your permission to photograph your child during the event, to help with future promotions of our programs. By giving us our consent, you authorize the Faculty of Applied Sciences (FAS) Outreach program of Simon Fraser University to photograph, audio record, video record, podcast and/or webcast your child (digitally or otherwise) without charge; and to allow the FAS Outreach Program to copy, modify and distribute in print and online, those images that include your child in whatever appropriate way either the FAS Outreach Program and/or SFU sees fit without having to seek further approval. No names will be used in association with any images or recordings.

Permission to share your child’s work:

We would like to seek your permission to share images and videos of your child’s work on our website, social media channels, and other digital outputs (such as e-newsletter) for the purpose of education and promotion. By giving us your consent, you also acknowledge and accept the risk that the Internet is not a secure medium; that any material posted on the Internet is accessible to anyone with Internet access.

Refund Policy:

The Faculty of Applied Sciences (FAS) Outreach Unit is able to offer refunds under the following circumstances:
- If you cancel your program registration more than 7 days before the program’s start date, you will receive a refund of the program fee minus a $35 cancellation fee.
- If you cancel your program registration 7 days or less before the program’s start date, no refund will be issued.
- There is no fee to switch to a different program week but this depends on space availability. Please contact sacoord@sfu.ca if you want to switch to a different program week.
- A refund upon receiving a written medical recommendation from a doctor will be issued. This amount will be calculated based on the number of days the participant attended the program.
- A refund may be considered upon receiving a written recommendation from program coordinator/manager outlining why the program is not suitable for the participant. This amount will be calculated based on the number of days the participant attended the program minus a $35 administration fee.
- If any program weeks are cancelled by FAS Outreach, a full refund will be issued

YES: I have read, understand, and agree to be bound by the above terms. (*)

Signature:

Sign my signature Type my signature (*)

Signature:

(type your full name)

To change or cancel a registration go to:	My Registrations
To make another registration go to:	Events


Organization:	Science ALIVE SFU
Event:	Invent the Future Program 2024
Date/Time:	Mon, 12-Aug-2024 - Fri, 23-Aug-2024

Person 1:	Already have a login? Click here Want to create a login? Click here
First Name:	(*)
Last Name:	(*)
Address:	(*)
Apartment:
City:	(*)
Postal Code:	(*)
Prov./State:
Country:	(*)
Home Phone:	(*)
Business Phone:
Mobile Phone:
Email:	(*)
	I have read and agree with the Terms of Use (*)


PARTICIPANT INFORMATION:
Participant First Name:	(*)
Participant Last Name:	(*)
Preferred Name:
Participant Pronouns (Optional):

Please select the grade first. Only programs for the participant’s grade will be shown.
Grade Completed as of June 2024:	(*)

PROGRAMS
IF-W7:	Week 7: Aug 12-16, Gr. 7-9, Cdn$ 265.00
IF-W8:	Week 8 (All Girls): Aug 19-23, Gr. 7-9, Cdn$ 265.00
Week 8 (All Girls) is reserved for Grade 7-9 girls and non-binary youth. Please confirm that you are aware of this participation criteria.
IF-W8-C:	YES: I confirm that I'm aware of this participation criteria. (*)

Pre-Care and Post-Care: Only those weeks corresponding to your program selection above will show up.
Week 7 (Aug 12-16):
Week 8 (Aug 19-23):

Promo Code:

Does the participant have experiences with the coding languages below?
Coding Experience:	(*)
Please rate the participant’s coding skills
Coding Skills:	(*)
Please rate the participant’s interest in coding.
Interest:	(*)
Please rate the participant’s interest in artificial intelligence
Interest AI:	(*)

*PLEASE NOTE: Only children 12 years or older are allowed to self-sign out
Sign Out Consent:	Self Sign Out, no adult signature required Guardian Sign Out (*)
Self Release: Your child signs themselves out at the end of the camp day. Guardian Release: Your child must be picked up by someone on their Guardian Release Consent List.
*Guardian Release Provide full names as listed on Government Issued ID**
Authorized Person 1:
Authorized Person 2:
Authorized Person 3:
Authorized Person 4:

Primary Parent / Guardian Information
Primary Parent/Guardian First Name:	(*)
Primary Parent/Guardian Last Name:	(*)
What is the relationship between the student and this adult (e.g. mother)?
Relationship:	(*)
Primary parent/guardian Email:	(*) Format: name@domain.com
Primary parent/guardian Phone Number:	(*) Format: ###-###-####
Secondary Parent/Guardian Information
Secondary Parent/Guardian First Name:
Secondary Parent/Guardian Last Name:
What is the relationship between the participant and this adult (e.g. mother)?
Relationship:
Secondary parent/guardian Email:	Format: name@domain.com
Secondary parent/guardian Phone Number:	Format: ###-###-####
Please check the box to confirm that you have reviewed the program details and items under the “Things to Know before Registering” section, which includes our refund and cancellation policies.
	YES: I have reviewed the program details and items under the “Things to Know before Registering” section, which includes refund and cancellation policies. (*)

ADDITIONAL INFORMATION
If possible, provide a contact that is different from the primary and secondary parent/guardian in the event we cannot reach both contacts.
Emergency Contact Name:
What is the relationship between the participant and this adult (e.g. mother)?
Relationship:
Emergency Contact Phone:	Format: ###-###-####

Participant's Personal Health Number:	On travel insurance (*)
Personal health and travel insurance information provided for each participant is only accessed for the purpose of medical emergency, and will be erased from our system when Summer Programs are complete. If you have travel insurance, please submit a copy of the insurance to sacoord@sfu.ca before the program start date.
Birthdate:	(*)
Gender:	Male Female Non-Binary Other Prefer not to say (*)

Allergy/Other Medical Information:	None (*)
Please indicate any medical/physical or behavioural needs that may affect your child’s participation in the program. This information will help us provide the necessary support to ensure a safe and inclusive learning environment.
Medical/physical or behavioural needs:	None (*)

Indemnity Agreement:	I agree to INDEMNIFY, PROTECT, DEFEND, AND HOLD HARMLESS the Faculty of Applied Sciences Outreach Program and SFU, and its governors, directors, officers, employees, and agents from and all costs, suits, claims, losses, and expenses, including all reasonable legal fees and other costs of litigation, resulting directly or indirectly from my [or my child’s] participation in the program, including but not limited to any damage to my property or personal injury to me [or my child], and for personal injury or property damage suffered by any third party resulting from my [or my child’s] actions whilst participating in the program, except to the extent that the same may be attributable to the negligence of the indemnified parties. YES: I have read, understand, and agree to be bound by the above terms. (*)
Medical Services Waiver:	I agree to allow SFU staff to provide or cause to be provided to me or my child such medical services as SFU or medical personnel consider appropriate. YES: I have read, understand, and agree to be bound by the above terms. (*)
Removal for Rule Breaking:	I acknowledge and agree that the FAS Outreach Program reserves the right to, and may, refuse further by any participant for infractions of community guidelines. Instructors will go over community guidelines on the first day of the program. YES: I have read, understand, and agree to be bound by the above terms. (*)
Photo Waiver:	We would like to seek your permission to photograph your child during the event, to help with future promotions of our programs. By giving us our consent, you authorize the Faculty of Applied Sciences (FAS) Outreach program of Simon Fraser University to photograph, audio record, video record, podcast and/or webcast your child (digitally or otherwise) without charge; and to allow the FAS Outreach Program to copy, modify and distribute in print and online, those images that include your child in whatever appropriate way either the FAS Outreach Program and/or SFU sees fit without having to seek further approval. No names will be used in association with any images or recordings.
Photo Waiver:	YES: I have read, understand, and agree to be bound by the above terms NO: I do not agree to the above terms (*)
Permission to share your child’s work:	We would like to seek your permission to share images and videos of your child’s work on our website, social media channels, and other digital outputs (such as e-newsletter) for the purpose of education and promotion. By giving us your consent, you also acknowledge and accept the risk that the Internet is not a secure medium; that any material posted on the Internet is accessible to anyone with Internet access.
Permission to share your child’s work:	I AGREE: By clicking “I agree”, I (a) give permission to FAS Outreach (with Science AL!VE) to share images and videos of my child’s work in the manner and for the purposes described above and (b) understand and accept the risk with posting digital material on the Internet I DISAGREE: By clicking “I disagree”, I do not (a) give permission to FAS Outreach (with Science AL!VE) to share images and videos of my child’s work in the manner and for the purposes described above and (b) accept the risk with posting digital material on the Internet (*)
Refund Policy:	The Faculty of Applied Sciences (FAS) Outreach Unit is able to offer refunds under the following circumstances: - If you cancel your program registration more than 7 days before the program’s start date, you will receive a refund of the program fee minus a $35 cancellation fee. - If you cancel your program registration 7 days or less before the program’s start date, no refund will be issued. - There is no fee to switch to a different program week but this depends on space availability. Please contact sacoord@sfu.ca if you want to switch to a different program week. - A refund upon receiving a written medical recommendation from a doctor will be issued. This amount will be calculated based on the number of days the participant attended the program. - A refund may be considered upon receiving a written recommendation from program coordinator/manager outlining why the program is not suitable for the participant. This amount will be calculated based on the number of days the participant attended the program minus a $35 administration fee. - If any program weeks are cancelled by FAS Outreach, a full refund will be issued YES: I have read, understand, and agree to be bound by the above terms. (*)

Signature:	Sign my signature Type my signature (*)
By signing below, I confirm that all information is correct and that I have read and agree to all of the waivers that I have selected above.
Signature:	(type your full name)
Signature:	Please sign here using your mouse (click and hold the mouse button on PC or Mac) or your finger (on tablet or phone)
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