Register — Saturday STEM Club | STEM Impact Center Kenya

Select Program

Saturday STEM Club

Every Saturday, 9:00 AM — 12 Noon

Holiday STEM Bootcamp

Monday – Friday, 9:00 AM — 12 Noon

Select Cohort *

1

Parent / Guardian Details

First Name

Last Name

Email Address

Mobile Number

Relationship to Student(s)

2

Emergency Contacts

Emergency Contact 1

Full Name

Mobile Number

Relationship

Emergency Contact 2

Full Name

Mobile Number

Relationship

3

Student Details

Student 1

First Name

Last Name

Age

Grade

School

Medical conditions or allergies?

NoYes

4

Consent & Acknowledgment

Program Participation

I understand that participation involves hands-on STEM activities conducted under the supervision of trained facilitators, and I agree to the Terms and Conditions as outlined on www.stemimpactcenterkenya.org.

Transportation

I accept full responsibility for my child's transportation to and from the program venue before and after program hours.

Data Collection

I consent to the collection and use of my child's personal data strictly for program administration and communication purposes.

Emergency Medical Authorization

In the event of an emergency, I authorize STEM Impact Center Kenya staff to seek necessary medical attention for my child.

Media Release

I consent

I grant STEM Impact Center Kenya permission to capture and use photographs and videos of my child in program reports, publications, social media, and materials shared with partners and the general public.

I do not consent

I understand that STEM Impact Center Kenya regularly documents its programs through photographs and videos for reports shared with partners and the general public. While every reasonable effort will be made to avoid capturing images or videos of my child, I acknowledge this cannot be fully guaranteed in group settings.

Photo & Media Notice — please read

Photographs and video are taken at every session for our records and program reporting. If you indicate "I do not consent" we will not knowingly publish your child's likeness in public-facing material, but in the rare event you spot your child in any of our public media (social channels, website, brochures, partner reports), please notify us at programs@stemimpactcenterkenya.org and we will take it down immediately.

By submitting this registration you indemnify STEM Impact Center Kenya from any incidental capture of your child's image in group photos or session footage taken in good faith for the purposes set out above, on the condition that the take-down request is honoured upon notification.

5

Digital Signature & Submit

By typing my name below, I, the undersigned parent/guardian, confirm that all information provided in this form is accurate and complete. I acknowledge that this digital signature carries the same legal weight as a handwritten signature.

Today: 6 May 2026

Full Name (Digital Signature) *

Saturday STEM Club Registration

Select Program

Parent / Guardian Details

Emergency Contacts

Student Details

Consent & Acknowledgment

Digital Signature & Submit