Girls Robotics – FIRST Robotics Canada

Girls Robotics Workshop

Participant First and Last Name(Required)

First Last

Participants Email(Required)

Participant Phone Number(Required)

Participants Mailing Address(Required)

Street Address Address Line 2 City Province Postal Code

Gender(Required)

Female

Grade(Required)

T-Shirt Size (Adult)(Required)

Are you currently part of a FIRST team?(Required)

Yes

Do you require any accommodations to participate in the Girls Robotics Workshop(Required)

Yes

Please tell us a little about the accommodations you need. Please DO NOT include food/dietary restrictions here(Required)

How did you hear about us?(Required)

Breakfast, lunch and snacks will be provided over the course of the two day workshop, along with a hydration station. Please let us know your preference. If you have certain dietary restrictions you are welcome to bring your own food.(Required)

Vegetarian

Non Vegetarian

Consent and Release

Consent(Required)

Please note that if you are 18 by the day of the event, you must sign this form, or if you are under 18 by the day of the event, your parent or legal guardian must sign this form online before you can submit your registration. If you have any questions, you can contact joanna.whitney@firstroboticscanada.org

The Participant identified above (“Participant”) desires to participate (as a team member, coach, mentor, judge, or in some other manner) in the FIRST® Robotics Competition, FIRST Tech Challenge, FIRST LEGO® League, or another FIRST program or Event (the “Programs”). As a condition of allowing the Participant to participate in a Program, FIRST Robotics Canada requires that the Participant (by their Parent/Guardian if under 18 years of age) agree to the terms of this Consent and Release Agreement.

1. (A) Participant (and the Parent/Guardian of a Participant under 18 years of age) understands and acknowledges that while particular rules, equipment and personal discipline may reduce the risks outlined below, participation in the Program will expose Participant to risks of injury and illness including, without limitation, injury and illness resulting from building, lifting, and using electrical/mechanical robots and robot components; using tools; other participants; dancing, physical activities; COVID-19* (see below) and other infectious diseases; and other associated activities. Participant (and the Parent/Guardian of a Participant under 18 years of age) understands that FIRST Robotics Canada does not select, employ, supervise or otherwise exercise authority or control over the coaches, mentors, and other participants in the Program. Participant, if 18 years or older, acknowledges and agrees they are primarily responsible for their safety. The Parent/Guardian of a Participant under 18 years of age recognizes and agrees that the Parent/Guardian is primarily responsible for the Participant’s safety and that the Parent/Guardian will monitor, as appropriate considering the age of the Participant and other factors, the Participant’s participation in the Program.

(B) COVID-19. Participant (or Parent/Guardian of a Participant under 18 years of age) understands and agrees that participation in the The Program presents certain risks and dangers to Participants, both serious and minor, arising from being exposed to the COVID-19 virus. COVID-19 is a disease caused by the SARS-CoV-2, declared by the World Health Organization as a global pandemic. Participant (or the Parent/Guardian of a Participant under 18 years of age) understands that COVID-19 is considered highly contagious and is primarily spread from person to person, including by asymptomatic persons. COVID-19 is more likely to spread when people are close to one another. Participant (or the Parent/Guardian of a Participant under 18 years of age) understands that, while participating in a FIRST Program, Participant will be near other persons, some of whom may be infected by, and able to spread, COVID-19. Participant (or Parent/Guardian of a Participant under 18 years of age) understands and acknowledges that, given the unknown nature of COVID-19, it is impossible to fully list every risk of contracting COVID-19. Nevertheless, some of the generally understood risks include health consequences, personal injury, illness, permanent disability and even death, and may include coughing, shortness of breath, difficulty breathing, fever, chills, shaking, muscle pain, headache, sore throat, loss of taste or smell, pain or pressure in the chest, confusion, upper respiratory distress syndrome, pediatric multisystem inflammatory syndrome, and other symptoms and risks (“COVID-19 Exposure”). Participant (or the Parent/Guardian of a Participant under 18 years of age) understands and appreciates that COVID-19 risks are inherent in participating in a FIRST Program and that Participant may contract COVID-19 as a result of participating in a FIRST Program. Participant (or the Parent/Guardian of a Participant under 18 years of age) agrees that Participant’s participation in a FIRST Program is voluntary. Participant and the Parent/Guardian of a Participant under 18 years of age hereby knowingly assume the risk of any COVID-19 Exposure. Participant (or the Parent/Guardian of a Participant under 18 years of age) understands and agrees that the waiver and release of the right to make injury claims stated below waives and releases the right to make all claims whatsoever related to COVID-19 Exposure and all claims for any resulting injury, disability, or illness up to and including death.

2. COVID-19 Symptom-Free Participation: Participant (or the Parent/Guardian of a Participant under 18 years of age) agrees that Participant will not participate in person in a FIRST Program if Participant or any individual residing in the same home as Participant For 2023 Girls that Google Event - September 23 and 24 2023, have had any symptoms of COVID-19 during the 14 days preceding the date of participation. Participant (or the Parent/Guardian of a Participant under 18 years of age) agrees that Participant will comply with any COVID-19 screening or exposure control practices which may be adopted by FIRST when participating in a FIRST Program and will also comply with any COVID-19 requirements of the state or local jurisdiction in which the Participant is participating.

3. In consideration for FIRST Robotics Canada allowing the Participant to participate in a Program, the Participant (and the Parent/Guardian of a Participant under 18 years of age for and on behalf of the Participant and the Parent/Guardian) assumes the risk of such participation and hereby releases, waives and holds harmless FIRST Robotics Canada and all of FIRST Robotics Canada’s directors, officers, employees, volunteers, and agents from any and all claims with respect to any and all accident, illness, injury, disease of any kind of/to the Participant (and the Parent/Guardian), including, without limitation, COVID-19 as described above disability, death or loss or other damages to person or property that may occur as a result of the Participant’s participation in the Program unless such injury to the Participant (and the Parent/Guardian), disability, death or loss, or other damages to person or property arising from the negligence or willful act of FIRST Robotics Canada or FIRST Robotics Canada’s directors, officers, employees, volunteers, agents or any person for whom FIRST Robotics Canada is in law responsible. 4. Participant (and the Parent/Guardian of a Participant under 18 years of age) understands that live broadcasts, photographs, videotapes, and other recordings may be made of participants in the Programs, including the Participant, by FIRST Robotics Canada and other organizations not under the control or direction of FIRST Robotics Canada. Participant (and the Parent/Guardian of a Participant under 18 years of age) consents to those broadcasts, photographs, videotapes, and other recordings and the use thereof (i) as part of a record of the Program and (ii) to promote FIRST and the Programs. If the Participant (and the Parent/Guardian of the Participant under 18 years of age) does not consent to be photographed, videotaped and/or recorded (i) as part of a record of the Program and (ii) to promote FIRST and the Programs, please notify FIRST Robotics Canada by email at communications@firstroboticscanada.org at least seventy-two (72) hours prior to attendance or participation at a FIRST Robotics Canada event. Participant (and the Parent/Guardian of a Participant under 18 years of age) has read this document and understands that this The consent and Release Agreement includes a waiver of the right to make injury claims that are intended to be legally binding.

Agreement. Electronic Signature: By signing this Agreement, the below Participant or Parent/Legal Guardian acknowledges and agrees that their electronic signature has the same legal effect and validity as their written signature and that this Agreement is valid and will be given the same legal effect as a written and signed agreement. Participant further acknowledges and agrees that no certification authority or other third-party verification is necessary to validate their electronic signature and that the lack of such certification or third-party verification will not in any way affect the enforceability of their electronic signature of this binding Agreement. Participant’s consent to the electronic signature applies only to this Agreement and does not apply to any separate transactions or communications with FIRST. Participants may request a paper copy of the completed and binding Agreement.

I have read and agree to the consent and release form

Parent/Legal Guardian Name(Required)

First Last

Parent/Guardian Phone(Required)

Parent/Guardian Email(Required)

Parent/Legal Guardian Signature(Required)