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KC Robotics Team Member Information 2018-2019
This form is used to collect information about student team members and their parents/guardians.
Student Information
All items with a star are required.
First Name *
Your answer
Last Name *
Your answer
Birthday *
MM
/
DD
/
YYYY
Student Grade *
Your answer
Student School *
Student Mailing Address *
Your answer
Student Phone Number *
Your answer
Student E-mail *
Your answer
Student Known Allergies *
Your answer
Parent/Legal Guardian Information
All items with a star are required.
Primary Parent/Guardian Last Name *
Your answer
Primary Parent/Guardian First Name *
Your answer
Primary Parent/Guardian Relationship to Student *
Your answer
Primary Parent/Guardian Phone Number *
Your answer
Primary Parent/Guardian Email *
Your answer
Primary Parent/Guardian Mailing Address (if different than student's) *
Your answer
Additional Parent/Guardian Last Name
Your answer
Additional Parent/Guardian First Name
Your answer
Additional Parent/Guardian Relationship to Student
Your answer
Additional Parent/Guardian Phone Number
Your answer
Additional Parent/Guardian Email
Your answer
Additional Parent/Guardian Mailing Address (if different than student's)
Your answer
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