10th Annual ZORA! STEM Conference

An “Education Day” Program for Students in Middle School (In-person & Virtual)

Friday, January 27, 2023; 8:00 AM – 3:00 PM

Full Sail University; 3300 University Boulevard; Winter Park, FL 32792

CLICK HERE TO REGISTER

10th Annual ZORA! STEM Conference

An “Education Day” Program for Students in Middle School (In-person & Virtual)

"*" indicates required fields

Name*

First Last

Home Telephone*

Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Student’s Grade Level

Parent’s/Guardian’s Name*

Parent’s/Guardian’s Address (if different from student’s):

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent’s Guardian’s Telephone*

Parent’s/Guardian Email*

In case of an emergency, please contact these persons

Name*

Telephone No.*

Medical Condition (if any, please describe)

Is medication prescribed or required?

Yes

Name of medication

SPECIAL NEEDS (Dietary, Religious, and Others)

Signature of Parent/Guardian*

Date*

School’s Details:

School’s Name*

School’s Telephone*

School’s Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Principal’s Name*

Principal’s Email

Lead Teacher: (This person will monitor the virtual classroom experience)

Permission to Participate in the
ZORA! ™ STEM Conference
An In-person & Virtual Event of the
34th Annual Zora Neale Hurston™ Festival of the Arts and Humanities
(ZORA! ™ Festival) on “Education Day,” Friday, January 27, 2023

For and in consideration of benefits to be derived from the furtherance of the educational programs of the School Board of Orange County, Florida (the “Board”), (I) (We), personally and on behalf of ___________________________________ (“Student”), do hereby consent, authorize and grant permission to the Board and OCPS and their respective members, superintendent, agents, employees and the representatives of each and the Association to Preserve the Eatonville Community, Inc. (P.E.C.) presenter of the ZORA!™ Festival, to take photographs, video, footage or likenesses with or without sound (collectively, “Images”) of the Student, and do further consent that such Images may be broadcast or published in perpetuity by all public media now known and in the future including, but not limited to, local newspapers, the Internet, websites, online, television or any other type of social media or any duplication of same for any purposes the Board and OCPS and the Association to Preserve the Eatonville Community, Inc. (P.E.C.) deem appropriate.

In granting such permission, (I) (We) give to the Board and OCPS and the Association to Preserve the Eatonville Community, Inc. (P.E.C.) all rights, title and interest (I), (We) may have in the pictures, negatives, reproductions or copies of the Images and waive any and all rights to approve of the use of the Images and waive any right to compensation for the publication or other use of the Images. The parent or legal guardian releases, discharges, covenants not to sue, indemnifies and holds harmless the Board and OCPS and the Association to Preserve the Eatonville Community, Inc. (P.E.C.) and the respective members, superintendent, agents, employees and the duly authorized representatives and assigns of each (collectively, the “Released Parties”) from any and all claims, damages, injuries to persons or property, causes of action, threats of litigation, loss, costs, expenses (including attorney fees) and liabilities of any nature whatsoever arising from or in any way related to the use of the Images.

Signature*

Date*

Permanent Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Relationship*

Phone*

Phone

This field is for validation purposes and should be left unchanged.

FRIDAY SESSION

Date

January 27, 2023

Time

8:00 AM - 3:00 PM

Location

Full Sail University; 3300 University Boulevard; Winter Park, FL 32792

10th Annual ZORA! STEM Conference

An “Education Day” Program for Students in Middle School (In-person & Virtual)

"*" indicates required fields

Name*

First Last

Home Telephone*

Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Student’s Grade Level

Parent’s/Guardian’s Name*

Parent’s/Guardian’s Address (if different from student’s):

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent’s Guardian’s Telephone*

Parent’s/Guardian Email*

In case of an emergency, please contact these persons

Name*

Telephone No.*

Medical Condition (if any, please describe)

Is medication prescribed or required?

Yes

Name of medication

SPECIAL NEEDS (Dietary, Religious, and Others)

Signature of Parent/Guardian*

Date*

School’s Details:

School’s Name*

School’s Telephone*

School’s Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Principal’s Name*

Principal’s Email

Lead Teacher: (This person will monitor the virtual classroom experience)

Signature*

Date*

Permanent Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Relationship*

Phone*

This field is for validation purposes and should be left unchanged.

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10th Annual ZORA! STEM Conference

FRIDAY SESSION

Date

Time

Location

FRIDAY SCHEDULE

Breakfast, Snack

Opening Plenary

Technical Careers in Entertainment

The Business of show Business

Lunch

Education for Entertainment

Campus Tours

Closing Session

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