Extreme STEAM Saturday Consent Form
Every participant in a Lawrence Technological University-sponsored program or event must read the program and event expectations and sign the program and event consent form prior to the beginning of the program/event. 

In addition, participants under the age of 18 must have the signature of a parent or guardian. Participation in the program/event is limited to students registered for the Lawrence Technological University program/event.
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Participant Name *
Participant Email *
Parent/Guardian Name (Emergency Contact) *
Parent/Guardian Phone Number (Emergency Contact) *
I, the undersigned, have enrolled and intend to participate in the Lawrence Technological University-sponsored program/event identified above. I acknowledge that I have read the program overview and voluntarily accept such risks normally incident to such activities. I have also read the “Program and Event Expectations” and agree to abide by the indicated directives. I agree to hold Lawrence Technological University and all its officers and employees free from liability in the event I suffer personal/property injury or damage as a result of participating in this program/event.

I further agree that I am solely responsible for my own equipment, supplies, personal property, and effects during the course of the program/event. I agree that all parties above whom I have hereby held free from liability are only responsible for the general supervision of the logistical/educational aspects necessary to provide a safe and successful program/event and that they cannot and do not guarantee my personal safety.

In the event that any medical attention is needed, I authorize the leader(s) of the program/event or any qualified individual to administer the first aid necessary to maintain health until a physician may be reached or other medical assistance obtained. I further authorize any physician to administer such medical or surgical treatment diagnosed as necessary.

Also, I hereby consent and authorize Lawrence Technological University, its successors, and assigns, to utilize photographic or video images of my child and/or audio recordings of his/her voice in Lawrence Tech advertising and promotion. Receipt of full consideration is hereby acknowledged and no further claims of any nature will be made.

By my electronic signature below, I hereby agree to and fully understand all of the above issues/conditions and accept full responsibility as outlined above.
Program and Event Expectations

Lawrence Technological University sponsors programs and special events to provide a comprehensive and diverse learning experience for program participants. Program/event participants and leaders are expected to conduct themselves in a professional and positive manner as representatives of Lawrence Technological University. All students must adhere to and be responsible for the Student Code of Conduct as part of their enrollment in the Lawrence Technological University Extreme STEAM Saturday Program. Failure to follow operating guidelines, instructor/staff directives, and the Student Code of Conduct may result in disciplinary action
(https://www.ltu.edu/cm/attach/f6843830-5bd4-40b1-87a2-e38692f1611e/student-code-of-conduct.pdf)

Expectations

Anyone with a history of medical problems should consult with their physician prior to the program/event to be sure that they are in condition to make the trip or participate in the event.
Any prescription medications required must be in their original containers clearly marked with patient and medical information. Be sure to take sufficient quantity for the duration of the program/event.
No drugs or alcohol are permitted at the program/event. Possession, use, sale, distribution, and transportation of alcohol, any controlled substance, illegal drug, and drug paraphernalia are prohibited.
No firearms, explosives (including fireworks), or other weapons are permitted on the program/event. The transportation, storage, possession, or uses of these items are prohibited.
Sexual harassment, sexual misconduct, lewd or indecent behavior, and sexual assault are prohibited.
Physical abuse, threats, intimidation, harassment, coercion, and/or other conduct that threatens or endangers the health or safety of any person are prohibited.
Interfering with normal college activities, including studying, teaching, research, and recreation, is prohibited.
Failure to comply with instructors/staff directives, engaging in prohibited conduct, or violation of any laws may result in disciplinary and/or legal action.
From the time the program/event begins and until it ends, participants must adhere to all college policies, procedures, and instructor/staff directives.
Participation is limited to those registered for the program/event.
Participant Electronic Signature *
Today's Date *
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Parent/Guardian Electronic Signature  (required if participant is under 18 years of age)
Today's Date  (required if participant is under 18 years of age)
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