Registration

General Registration Information - All Registrants

Please complete for yourself and indicate your role.

Individual Type - Robotics

Student

Team Captain

Alumni

Adult Mentor

Design Review Committee

Adult/Parent/Guardian

Prefix: First Name: Last Name: Street Address: City: State: Zip Code: - Primary Email (not school email): Alternate Email: Your Phone: Alternate Phone:

Additional Information - All Registrants

Note that only active mentors and team members receive complementary t shirts.

T-Shirt Information:

Small

Medium

Large

XXL

Race

Asian or Pacific Islander

Black or African American

Hispanic or Latino

Native American or Alaskan Native

White or Caucasian

Multiracial or Biracial

A race/ethnicity not listed here

Gender: Graduation Year

Current Team Members Only

Students please complete

Student Interests (Select all that apply) Special Dietary Needs/Allergies Parent 1 First Name: Parent 1 Last Name: Parent's Email: Parent's Cell Phone: Parent 2 First Name: Parent 2 Last Name: Parent Secondary Email: Parent Secondary Cell Phone:

Adults Only - Parents, Mentors, Alumni

Would you be interested in mentoring (Select all that apply)? Please elaborate: preferred days of the week, times, areas of expertise, etc.