Youth Interactive Safety Lab 2019

Thank you for your interest in the 2019 NOYS Youth Interactive Safety Lab!

When: Monday, October 21, 2019 9:30 am - 1:30 pm

Exhibitor Set up 7:30 am - 9:30 am

8:3 am - 9:30 am Registration

9:30 am - Students begin rotation - Interactive Lab Stations

11:30 am - 12:30 pm - Lunch distribution - lab stations remain open

1:30 pm Adjourn

Where: Glenmont Local Park (3201 Randolph Road, Wheaton, MD 20906)

How: Youth move through interactive lab stations in small groups and receive a stamp on their "passport" for each completed activity. See it in action!

Please register below.

Question Title

* 1. Are you attending as a:

Teacher/Educator/Advisor with youth attendees!

Teacher/Educator (unaccompanied)

Lab Partner/Exhibitor!

Other awesome adult!

If attending with youth, please indicate the number of youth anticipated.

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* 2. Registrant Contact Information (Please register other adults or co-workers seprately)

Name *

School/Organization *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

Phone Number *

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* 3. Photo & Video release: I hereby grant to NOYS and its representatives the right to photograph, videotape, or otherwise digitally collect my likeness, name, voice and sounds (as “Works”) and assign and grant all rights in these Works to NOYS. This gives NOYS the right to use or sublicense these Works without compensation or prior inspection and without any claim of defamation, invasion of privacy, violation of my right of publicity, copyright infringement, or any claim of video or audio alteration or faulty mechanical production, in NOYS’s discretion, in all media, for the promotion of NOYS and its mission and programs.

Yes, I agree

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* 4. Teachers/Educators/Advisors Please acknowledge that you understand each student needs a signed liability waiver to participate.

Yes, I understand

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* 5. Lab partners & Exhibitors - Please upload a high quality logo for your organization/agency that will be used for signage.

File size limit is 16MB

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.

Choose File

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* 6. Lab Partners & Exhibitors - tell us a little about your activity!

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* 7. You may have noticed we don't have a registration fee! Would you consider a $25 donation to NOYS and the Youth Interactive Safety Lab?

Yes! - $25 USD

Not this time - $0 USD

You will pay at the end of this survey.