JD02-04052026_Registration_and_Consent

BioMedEdu Programs - Junior Doctors Program Student Registration & Required Consents

Please submit a separate registration form for each student, even for siblings or twins. Thank you!

BioMedEdu 2026 Junior Doctors Program – Human Diseases: DNA

Date: April 5, 2026 Sunday 1:00 PM- 3:30 PM

Location: The Health Museum

Fee: $95

Because space and materials are reserved in advance, registration fees are non-refundable. We encourage families to review the schedule carefully and confirm availability before registering. Thank you for understanding!

Registration & Important Notes

Space is limited. Registration will close once capacity is reached.

A waitlist will be available if the program fills; families will be contacted if a spot opens or if future sessions are added.

For more information, please visit https://www.biomededu.org
If you have questions, contact us at info@biomededu.org
You will receive an email copy of your completed registration after submission.

Student First Name*

Student Last Name*

Student Email (Please ensure this email address is correct.*

example@example.com

School Name*

School District Name

School City and State*

Parent Full Name*

Parent/Guardian Email (Please ensure this email address is correct. Your confirmation and completed registration will be sent here.)*

example@example.com

Medical Liability Waiver & Emergency Medical Authorization: I acknowledge that participation in Institute-organized educational activities may involve inherent risks. I agree that the Institute for Biotechnology and Biomedical Education and The Health Museum and its representatives are not responsible for injuries or medical conditions except as required by law. In the event of a medical emergency, I authorize appropriate medical care for my child and understand all associated costs are my responsibility.*

I have read the consent carefully and agree to the terms.

Please list any allergies medical conditions or special needs

Phone

Format: (000) 000-0000.

Program Fee - Non-refundable. Because space and materials are reserved in advance, registration fees are non-refundable. We encourage families to review the schedule carefully and confirm availability before registering. Thank you for understanding!

Program Fee, Junior Doctors

The program fee includes materials and admission to The Health Museum. Because space and program resources are reserved in advance, registration fees are non-refundable. We encourage families to review the schedule carefully and confirm availability before registering.

If unexpected circumstances arise, please contact us. We will do our best to help when possible. Thank you for your understanding.

$95.00 Quantity

Total

$0.00

Payment Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Today's Date*

Date

By entering my first and last name below, I confirm that I am the parent or legal guardian of the student, have read and understood this Parental Consent & Medical Liability Waiver, and agree to its terms. I acknowledge that my electronic signature is the legal equivalent of a handwritten signature and give permission for my child to participate.*

ParentLegal Guardian

Important: please click Submit to complete your registration or save it and come back to complete. You will receive an email copy of your completed registration after submission.

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