We're so excited you're here!
ChickTech: High School started off with a two-day kickoff event in November but it's not too late to join us. Through really fun, hands-on workshops that allow you to create projects, you'll learn about all the exciting stuff you can do with tech. No experience with this kind of thing? Don't worry! Our workshops are designed especially for you. What's Next: We host monthly workshops (starting in November through August) where you get to build robots, develop code and hack servers. To register for our program please follow the prompts here.
 
First Name *

 
Last Name *

 
Phone Number *

 
Can we text you? *

     
 
What grade are you in? *


 
What is the name of your school? *

 
What zip code do you live in? *

 
What size shirt do you wear? *


 
Will you need help with transportation? *

     
 
Do you agree to our code of conduct? *

ChickTech is committed to providing a friendly, safe and welcoming environment for all, regardless of gender, sexual orientation, disability, ethnicity, or religion. This code of conduct outlines our expectations for participant behavior as well as the consequences for unacceptable behavior.

• Be considerate, respectful, and collaborative.
• Refrain from demeaning, discriminatory or harassing behavior and speech.
• Be mindful of your surroundings and of your fellow participants.
• Alert event organizers if you notice a dangerous situation or someone in distress.

Unacceptable behaviors include: intimidating, harassing, abusive, discriminatory, derogatory or demeaning conduct by any attendees of ChickTech events. All ChickTech venues may be shared with members of the public; please be respectful to all patrons of these locations.

Harassment includes: offensive verbal comments related to gender, sexual orientation, race, religion, disability; deliberate intimidation, stalking or following; harassing photography or recording; sustained disruption of talks or other events; inappropriate physical contact, and unwelcome sexual attention.

Unacceptable behavior will not be tolerated whether by other attendees, organizers, venue staff, sponsors, or other patrons of ChickTech venues. Anyone asked to stop unacceptable behavior is expected to comply immediately. If a participant engages in unacceptable behavior, the event organizers may take any action they deem appropriate, up to and including expulsion from the event without warning. If you are subject to unacceptable behavior, notice that someone else is being subject to unacceptable behavior, or have any other concerns, please notify an event organizer as soon as possible.

License & attribution: Creative Commons Attribution-ShareAlike
     
 
Emergency Contact Information

 
Full Name *

 
Relationship to student. *

 
Phone Number *

 
Email Address *

 
Emergency Contact #2 Information

 
Full Name *

 
Relationship to student. *

 
Phone Number *

 
Email Address *

 
Describe any medical conditions you the student may have, plus any medications.

Please put N/A if you have nothing to report.
 
Who is your family doctor and how do we contact them?

 
Parent's email address *

 
PARENT: Do you consent to the below?

The next section requires a parent or guardian's approval if you are under 18. Participants without a parent or guardian may have an "approved adult" fill this out. Participants over 18 may fill out this section acting as their own guardian. If your parents or guardians don’t have access to the internet,  please download and print the form. If you choose to fill out the paper form, you can skip the next section.

DOWLOAD PAPER VERSION HERE: http://tinyurl.com/z6n2t6n

I, parent, guardian, or approved adult of (the “Student”), hereby give my consent to the Student’s participation in ChickTech: High School 2016 (a year-long program that runs from November 2016 to as late as October 2017). I understand that the Student may be transported to and from the ChickTech: High School 2016 events and that the Student may be engaged in activities such as soldering, working with tools, computers or other equipment. The Student will be supervised by ChickTech volunteers during the scheduled ChickTech: High School events. In consideration of the permission granted to me and to the Student for the Student to participate in ChickTech: High School 2016 the undersigned parent or legal guardian, to the extent permitted by law, do hereby:

(1) assume any and all risk and liability for all losses, damages, damage to property, injuries or death to the Student which may arise in connection with travel to/from or participation in ChickTech: High School 2016 sponsored by ChickTech or its affiliates, and hereby, for the Student and for myself and our heirs, executors, administrators, successors and assigns, do release and discharge the ChickTech and each of its affiliates, officers, directors, employees, volunteers, predecessors, successors, representatives and assigns (collectively “ChickTech”), from any and all claims, actions, and liabilities arising from or relating to with travel to or participation in activities, programs or functions of ChickTech: High School 2016, and;

(2) grant permission for videographic, photographic or audio recording of the Student’s participation in the activities, programs or functions of ChickTech: High School 2016, and for the use of such recordings by or with the consent of ChickTech for promotional and educational purposes. This consent form will remain in effect until October 31, 2017. I, the undersigned, have carefully read the foregoing consent and release form and know and understand the contents thereof. I sign this consent and release voluntarily and with knowledge of its significance, and intend to be legally bound thereby.
     
 
Do you have a friend that you'd like to recommend for ChickTech High School?


You are all set! We will be in touch with next steps. 

Questions or thoughts? email us at Seattle@chicktech.org