STEM Coding Program Volunteer Registration Form
This form captures information for the BDPA Atlanta Technology Foundation, Inc coding program.  All information collected will be used for the program.
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Volunteer Name *
First and last name
Company
if applicable
Email *
Phone number
Address
T-shirt size
*
Volunteer Interest Pathway(s) *
Required
Other Details *
Describe "other" or details on your background
Affiliations / How did you learn of our program?
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Release *
I hereby release and discharge, and by these presents do for myself, my heirs, executors, administrators and assigns release and forever discharge BDPA, STEAMsport, Inc. , H.J. Russell and Company, and their respective members, employees, contractors, agents and representatives, of and from all claims, demands, damages, actions, causes of action or suits at law or in equity, of whatsoever kind or nature which I now have or may have hereafter, for or because of any matter or thing done, omitted, or suffered to be done by said entities prior to and including the date hereof, and particularly on account of all injuries both to person and property resulting, or to result, from participation in programs and activities sponsored by discharge BDPA, STEAMsport, Inc. , H.J. Russell and Company, and their respective members, employees, contractors, agents and representatives.

 

Additionally, I hereby grant to BDPA, STEAMsport, Inc., H.J. Russell and Company my absolute and unconditional permission to use, without charge, any and all photographs, video reproductions or other like kinds of imagery production taken during the event in which l or my likeness or image, or the likeness or image of my child or ward, may appear as the subject matter for publicity or any other purpose. I understand that my name or the name of my child or ward may be included with the photograph or other image.

 

The intent of this release is not to sell or publicize individual images of the parents or children attending this program. It is intended to make you aware that these images may appear with others or in groups on brochures, internal publications, or press releases.

 

IN WITNESS WHEREOF, the undersigned hereby executes this release.
Signature *
By entering name and submitting form you agree that all information in this form is accurate and you agree to usage by BDPA Atlanta Technology Foundation, Inc and it's affiliates.
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