Sonia Math Day for Girls

Check-in for this event opens at 9:00 am.

PARENT or GUARDIAN CONTACT INFORMATION

First Name*

Last Name*

Phone Number*

Relationship to Participant

Email Address*

PARTICIPANT CONTACT INFORMATION

Participant's First Name*

Participant's Preferred Name (if different)

Participant's Last Name*

Participant's Email Address*

Confirm Participant's Email Address*

Participant's Birth Date*

Mailing Address*

Country

Street

City

Region

Postal Code

Participant's Current School

List the participant's current or most recent Math class.

Event Planning

T-Shirt Size*

Small

Medium

Large

XLarge

Boxed lunches will be provided by McAlister's Deli; select one option below.*

To discuss alternative food options email Tracy Weyand (weyand@rose-hulman.edu).

Does the participant have any medical conditions or required accommodations we should be aware of?

Yes

No

How did you hear about this program?

Participant Waivers

Assumption of Risk and Release

By acknowledging the Assumption and Risk and Release, the individual named on the registration form wishes to participate in the Sonia Math Day for Girls event described in this form and recognizes that there are risks of damage or injury arising from this event or from other activities (including travel) that may be associated with the participation in the Sonia Math Day for Girls event. By checking the box below, the participating individual voluntarily agrees to assume and/or incur all risks of loss, impairment, damage, or injury of whatever kind, including death that may result in whole or in part of acts of omissions, negligence or other unintentional fault of the Sonia Math Day for Girls event or Rose-Hulman Institute of Technology. In addition, the participant (including his/her heirs, assigns, and personal representatives) agrees to release, hold harmless, and indemnify Rose-Hulman Institute of Technology from and against any claims, demands, actions, causes of action, lawsuits, expenses, or losses (including attorney fees) on account of property damage or personal injury (including death) arising out of or attributable to the individuals travel to or participating in the Sonia Math Day for Girls event. This Assumption of Risk and Release Waiver applies to Rose-Hulman Institute of Technology and all of its trustees, officers, directors, managers, servants, agents, faculty, staff, students, volunteers, employees, advisors, and/or representatives. By signing this form, I acknowledge that I have read and understand the document.

I agree to the above assumption of risk and release waiver for participation in Sonia Math Day for Girls.*

Photo/Video Waiver

Rose-Hulman Institute of Technology reserves the right to photograph and record video of program participants and to publish likenesses in Rose-Hulman publications, video, websites, news media, social media, or other recruitment or promotional materials. By signing this form, I grant permission for my childs image to be used as described above.

I agree to the above photo/video waiver for participation in Sonia Math Day for Girls.*