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2021 Academy Ambassador Sign Up Form

Thank you for your interest in becoming a 2021 Academy Ambassador!

Academy Ambassadors volunteer to amplify the importance of STEM literacy and science-based decision-making on social media. With your support, we can continue to advance STEM literacy and grow public support for science around the world. To sign up as a 2021 Academy Ambassador, you will be asked to take the following actions:

  1. Complete and submit this form
    • Note, if you are under 18, your parent or legal guardian must also fill out the Parent/Guardian Permission section at the bottom of this form.
  2. Follow the Academy on Twitter, Facebook, and Instagram
  3. Complete a minimum of 2 qualifying social media actions per month in 2021. Qualifying social media actions include any of the following:
    • Sharing or re-tweeting Academy social media content, using an Academy hashtag (list to be provided)
    • Creating and posting your own content in support of STEM literacy, using an Academy hashtag

Starting in 2021, participating Ambassadors will receive a regular newsletter with links to suggested social media content and activities. In recognition for their volunteer efforts, participating Ambassadors receive a Digital Badge that can be added to a LinkedIn profile, shared on other social media channels, or embedded on a personal website or blog. Participating Ambassadors will also be recognized at the end of 2021 in a news item on the Academy’s website.

Please be sure to carefully review the Academy Ambassador Community Guidelines before completing this form. If you have any questions about the Ambassador program, please email

In consideration for receiving permission from the New York Academy of Sciences for my child (named above) to participate in the Academy's Ambassador Program, I agree as follows:

• 1. I represent that I am the parent or lawful guardian of the minor child named below.
• 2. If my child is accepted to participate in the Ambassador Program, I agree to be responsible for directing and causing my child to adhere strictly to all applicable rules, regulations, policies, guidelines, and instructions of the Ambassador Program, including those concerning safety, general decorum, and conduct.
• 3. I acknowledge and agree that my child’s participation in the Ambassador Program is only confirmed after this document has been signed and that the Ambassador Program, in its discretion, may end my child’s participation at any time.
• 4. I agree and understand that I am responsible for the actions of my child. I release, discharge, and hold harmless the Academy and their respective officers, directors, staff, and employees to the fullest extent permitted by law, from any and all claims and liabilities, including claims for negligence or gross negligence, which may arise in connection with this program, except those that may arise due to the intentional wrongdoing of an Academy officer, director, staff member, or employee.
• 5. I agree to permit the Academy and its representatives to make use of my child’s image, voice and/or conversation (“likeness”) in printed, electronic or other media form, now known or hereafter developed. My child’s likeness may be used by the Academy, including public relations, fundraising, promotional, recruitment or educational materials. The media form in which their likeness has been captured may include printed or electronic publications or communications, websites, or other means of distribution or transmission, now known or hereafter developed. I hereby waive any right to inspect or approve any such media and authorize the use of my child’s likeness in perpetuity, and without any compensation to me or my child. I hereby assign all right, title and interest in all such media capturing my child’s likeness, and agree that all such media shall be owned by the Academy.
• 6. This Consent, Waiver, and Release shall be governed by and construed and interpreted in accordance with the laws of the State of New York, USA, without regard to conflicts or choice of law rules or principles. All legal actions and proceedings relating in any way to the Ambassador Program or this Consent, Waiver, and Release shall be brought exclusively in the federal or state courts sitting in the State of New York, USA, and I waive any objection to jurisdiction and venue in such courts.
• 7. I hereby give my permission for my child named above to participate in this Program, according to the terms and conditions stated above. By signing below, I confirm that I have fully informed myself of the contents of this consent, waiver, and release by reading it before I signed it, and I have signed and entered into it voluntarily.