The 2020 Spellman High Voltage Electronics Clean Tech Competition

Parental Consent and Release

I, ________________________________________ [print full name], am the Parent / Legal Guardian of minor

child ____________________________________ [print full name] (“Child”). I hereby grant permission for Child to
participate as a member of a student team (“Team”) in the 2020 Spellman High Voltage Electronics Clean Tech Competition
(“Competition”) presented and administered by the Center for Science Teaching and Learning (“Administrator”) under the
official rules of the Competition (the “Rules”) available on the Competition website at www.cstl.org/cleantech/ .

On behalf of Child and myself:

1. I acknowledge that I have read and agree to the Official Rules and Regulations and that Child is eligible to
participate in the Competition as a member of a student team (“Team”).

2. I hereby grant permission to Administrator to use Child’s name, photograph, likeness, school, city and state and any
video footage of winners for programming, advertising, publicity and promotional purposes without compensation (unless
prohibited by law) and without prior approval or inspection. I understand that some of these materials may appear online,
including as part of the Competition’s, Administrator’s and/or Sponsors’ websites, where anyone with Internet access can
view this information.

3. I acknowledge and grant permission to the Competition to livestream the judging process to the general public.
While the public will not be viewable to Teams or be able to interact with them in any capacity, they will have full view of
the judging process and interview.

4. I hereby release, discharge and hold harmless Administrator, their respective affiliates and subsidiaries, agents
and representatives, and their respective officers, directors, members and employees, from any and all claims, injuries,
liability, losses, damages, costs and expenses of any kind, including reasonable attorneys’ fees, arising out of or relating to
Child’s participation in the Competition or acceptance, use or misuse of a prize, including, without limitation, personal
injury, property damage, and claims based on publicity rights, copyright, trademark, defamation or invasion of privacy.

_________________________________ __________________________
Signature of Parent/Guardian Date (MM/DD/YY)

_________________________________
Print Name of Parent/Guardian

Parent/Guardian Information

Home Address: ________________________________________________________________________

Street Address City/Town State Country Zip Code

Telephone: _________________________ (Include county code if outside of USA)

Email: ___________________________________________

Child’s Team Name: _______________________________________

Child’s Team Leader: ____________________________________________________

Title Given Name Surname

Child’s Affiliated School/Organization: ____________________________________________________