UIUC MakerGirl Academy/IDEA Lab Participant Registration Form

Step 1

polaroid banner with photos of girls designing 3D printed items at a MakerGirl session!

Welcome MakerGirl Parent! We are so excited to meet your MakerGirl soon. Please complete the registration below.

Level 1 - Future Makers (1.5 hours)

Introduction to 3D printing and how it can be used in different industries (themes ranging from 20+ different topics)
Introduction to computer-aided design (CAD)
Learn about famous women in STEM
Students can present what they created to the class
Target age range: 11 - 14 years old

Sessions:

Architecture: April 13th, 2024 @ 1-2:30pm for girls ages 11-14

Session Location:

IDEA Lab

Grainger Commons 2nd Floor (Room 230-235)

Grainger Engineering Library

1301 West Springfield Avenue

Urbana, IL 61801

Please complete the registration below by selecting the date & time!

Which theme are you registering for (One registration required for each MakerGirl)?

Level 1 Future Makers: Architecture: April 13th, 2024 @ 1-2:30pm for girls ages 11-14

Step 2

MakerGirl Parent/Guardian Information

Please complete the following section with your/parent/guardian information. This information will be used to send all communication about the session.

Parent/Guardian First Name

Parent/Guardian Last Name

Preferred Email Address

PersonalWork

Preferred Phone Number (in case of emergency))

HomeWorkMobile

Work Email address

Personal Email address

Home Phone Number

Work Phone Number

Mobile Phone Number

What is the parent/guardian's educational background?

Some high schoolHigh school diploma/GEDAssociate's DegreeBachelor's degree or higher

MakerGirl Information

Please complete the following section with your child's information. This allows us to create usernames needed to access our software during the session.

Participant First Name

Participant Last Name

Age

Birthdate

Step 4

The safety and privacy of your MakerGirl is our top priority. In the case where we would want to use a photo or image of your MakerGirl to celebrate her and her work, we want to make sure we get your permission to do so.

As the injury form pertains mostly to in person, we ask that you acknowledge that we are not responsible for the physical safety of your MakerGirl while on virtual session.

If you have questions about either release form, please contact our team at info@makergirl.us

Photo Appearance Release Form

I, ___(Parent Name)___, hereby consent to the photographing of my child, __(MakerGirl Name)_____ and/or myself and consent to the use of these photographs in addition to our first names for promotional and commercial purposes including, but not limited to flyers, websites, blogs, testimonials, videos, etc. I understand that the term “photograph” as used herein includes both still images and video footage.

I further consent to the reproduction and/or authorization by MakerGirl to reproduce and use said photographs and/or recordings. Further, I understand that others may, with or without the consent of MakerGirl, use and/or reproduce said photographs and recordings.

I allow MakerGirl to use participant’s name(s) and e-mail exchanges and allow any testimonies, stories, and quotes to be used by MakerGirl.

I hereby release MakerGirl and its members, and any of its associated or affiliated organizations and their members, from any and all claims on account of such use as described above.

Injury Release Form

I hereby voluntarily release and discharge MakerGirl, its agents, servants, interns, and employees from any and all claims for injury, illness, death, loss or damage, which participant's name(s) may suffer as a result of my child's participation in these activities. I understand that MakerGirl assumes no responsibility for injuries and illnesses that participant's name(s) may sustain as a result of her participation in this program or related with activity.

I hereby release MakerGirl and its members, and any of its associated or affiliated organizations and their members, from any and all claims on account of such use as described above.

I, the parent/legal guardian of the individual named above, have read this release and agree to its terms and conditions. My signature on the following page agrees to the terms and conditions above.

Step 5

Please provide the shipping address for your MakerGirl so we can ship their 3D print after the session is complete. This process is conducted by VOLUNTEERS and may take up to 10 weeks. Please pardon any printing issues or discrepencies. All prints will be printed in ONE color.

If your address is invalid or incorrect, we will not be able to ship your MakerGirl their 3D print.

Shipping Address

First Name

Last Name

Street (including unit/apartment # as applicable)

City

State/Province

Postal Code