IRA Innovate : FLL Registration Form
Please read, and sign the team contract before you fill this form.
Registration will close June 2nd 2019.
Team Meeting Time-Fridays-5:00 to 7:00 p.m , Sundays-2:00 to 5:00 pm.
Address: 120 Manchester Drive, IL 60089
Contact us at (312) 208-5453 or gkjunejafll@gmail.com
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Student Birth Date *
MM
/
DD
/
YYYY
Student Full Name *
Parent Full Name *
Email *
Parent Phone Number *
Emergency Phone Number *
Address *
Dietary restrictions *
I understand that I will have to pay: *
Required
I understand that additional expenses could incur during FLL season.Including, but not limited to field trips, travel to competitions, snack for teams and presentation equipment. *
Sponsorship/Donation.Please select Event/Product that you would like to sponsor or donate for: *
Select an amount.
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Fundraising Opportunities *
Connections with Expert/Local Businesses *
Payment
If sending cash,,please send it in a sealed envelope with "FLL registration" written on it. Check needs to be made payable to "IRA Innovate"
Registration fee/sponsorship money will be paid in: *
Required
Photo/ Audio Release for Minors (if under 18)
I understand that photo / audio of my student may be used in presentations, and team websites . I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.
I give permission to use my student's photo/audio or both for team presentations,and team websites *
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