American STEM Rubik’s Cube Workshops Registration Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Parent/Guardian Full Name *FirstLastRelationship to Student *Phone number *Email Address *Home Address *Student Full Name *FirstLastBirthday *Gender *School Name *Grade Level (2024-2025 school year) *3rd grade4th grade5th grade6th gradeRace/Ethnicity *Please selectAmerican Indian or Alaska NativeAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or Other Pacific IslanderWhiteOtherI prefer not to answerPlease list any allergies, medical conditions, or special accommodations neededPlease select the workshop date(s) you are interested in attending *Saturday 09/07/2024 1pm-3pm (Full)Saturday 09/14/2025 1pm-3pm (Full)Saturday 09/21/2024 1pm-3pm (Full)Saturday 09/28/2024 1pm-3pm (Full)Saturday 10/19/2024 1pm-3pm (Full)Saturday 10/26/2024 10am-12pm (McLean, VA)Saturday 11/16/2024 1pm-3pm (Fairfax, VA)Saturday 01/11/2025 10am-12pm (McLean, VA)Saturday 02/08/2025 10am-12pm (McLean, VA)Saturday 03/01/2025 1pm-3pm (Fairfax, VA)Saturday 03/15/2025 10am-12pm (McLean, VA)Saturday 03/22/2025 1pm-3pm (Fairfax, VA)Saturday 04/26/2025 10am-12pm (McLean, VA)Saturday 05/10/2025 1pm-3pm (Fairfax, VA)Saturday 05/17/2025 10am-12pm (McLean, VA)Saturday 05/31/2025 1pm-3pm (Fairfax, VA)Please select the date that best fit your schedule. Seats will be allocated on a first-come, first-served basis. If the session you have chosen is full at the time of your registration, you will receive an email requesting you to select another available session. We appreciate your understanding and flexibility. Thank you for your interest in our workshops!Are you interested in participating in the 2025 Rubik's Cube competition? *Yes, I would like more information about the competition as it becomes available.No, I am not interested in participating in the competition.Are you interested in building a Rubik's Cube solver? (Learning objectives include 3D modeling, 3D printing, Electronics, engineering, coding, etc.) *Yes, I’m interested in building a Rubik’s Cube solver.No, I am not interested at this time.Would you like to receive information about future American STEM workshops via email? *Yes, please keep me informed about upcoming events and workshops.No, I am not interested at this time.Please confirm your commitment to attend the selected workshop *I confirm that my child will attend the workshop(s) as selected above and commit to notifying American STEM in case of any changes to our availability.Consent to Participate, Waiver of Liability, and Photo/Video Release *I hereby give my consent for my child/self to participate in the American STEM Rubik’s Cube Workshop. I acknowledge that the workshop involves various activities that may include the use of tools, equipment, and materials. I understand and accept the potential risks associated with these activities and agree to hold American STEM, its officers, agents, and employees harmless from any claims or liabilities arising from participation. By signing this agreement, I agree to hold American STEM entirely free from any liability, including financial responsibility for injuries incurred before, during, or after the activity. I certify that my participation/my child’s participation is voluntary, and I have been made aware of the risks. Additionally, I do not have any conditions that may increase my likelihood of injury. I further agree to abide by all rules and regulations governing the American STEM Rubik’s Cube Workshops, and to follow any instructions or guidelines provided by American STEM or its representatives to ensure a safe and positive learning environment. I hereby grant permission to American STEM to take photographs and video recordings of me/my child during the workshop. I understand that these images and videos may be used for promotional purposes, including but not limited to, American STEM’s website, social media, brochures, and other marketing materials. I waive any rights to compensation or ownership of the images and videos.Submit