Register for Robotics Classes | JoBotics STEM Programs

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Parent First Name *

Parent Last Name *

Parent Email *

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Student First Name *

Student Last Name *

Student Age *

Student Grade Single

Emergency Contact

Contact Full Name *

Relationship to Student *

WAIVER FORM

Medical Information & Consent

List any allergies, medical conditions, or special needs:

By checking the boxes below you agree *

In the event of an emergency, I authorize Jo-Botics staff to obtain medical treatment for my child if I cannot be reached.

I understand that Jo-Botics classes involve hands-on activities including robotics equipment, small parts, tools, and computer devices. I acknowledge there are inherent risks including, but not limited to, minor injuries, equipment-related incidents, or accidental damage. I voluntarily allow my child to participate and assume all risks associated with participation.

I hereby release, waive, and discharge Jo-Botics, its owners, instructors, and affiliates from any and all liability, claims, demands, or causes of action arising out of or related to any loss, damage, or injury that may be sustained by my child during participation, whether caused by negligence or otherwise, to the fullest extent permitted by law.

I agree to indemnify and hold harmless Jo-Botics from any claims, damages, or expenses (including legal fees) arising from my child’s participation.

I understand that students are expected to follow instructions, respect others, and use equipment appropriately. Disruptive or unsafe behavior may result in dismissal from the program without refund.

I understand that students will use laptops/iPads and agree they will follow Jo-Botics guidelines. I acknowledge misuse may result in restricted access or removal from class.

Missed classes are not guaranteed to be made up / Refunds are not provided after the program begins unless otherwise stated / Jo-Botics reserves the right to cancel or reschedule classes

Photo & Media Release *

YES, I give permission for my child’s photo/video to be used for promotional purposes

NO, I do not give permission

I have read and fully understand this agreement. I acknowledge that I am signing it freely and voluntarily.

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