2019 DI Regional Tournament Registration
After submitting form, please send tournament fee ($150 per team and $50 per Rising Star team) payable to Intermediate District 287 by January 11, 2019 to:
Intermediate District 287
Attn: Kim Kallroos
1820 Xenium Lane N
Plymouth MN 55441
Membership Name (School Name or Program Name)
Your answer
Membership Number (ex. 123-00000)
Your answer
Team Nickname
Your answer
School District
Your answer
Region:
Please choose one region only. (Teams will perform in their assigned regions. For more information , go to www.mndi.org and look for tournament assignments).
Region:
Challenge:
Choose one challenge. Please inform us if your team is performing more than one challenge.
Challenge:
Competition Level:
Please choose one. See Rules of the Road (page 8) to determine your age/grade level.
Competition Level:
DI Coordinator Information:
DI Coordinator Name:
Your answer
DI Coordinator Cell Phone Number:
Your answer
DI Coordinator Email Address:
Your answer
DI Coordinator Street Address:
Your answer
DI Coordinator City:
Your answer
DI Coordinator Zip Code:
Your answer
Team Manager Information:
If you are managing more than one team, please let us know the team number, challenge, level and nickname of your team(s). If you have team members on more than one team, please let us know the same information. This information can be entered in the special considerations tab.
Team Manager 1 Name:
Your answer
Team Manager 1 Email Address:
Your answer
Team Manager 1 Cell Phone:
Your answer
Team Manager 2 Name:
Your answer
Team Manager 2 Email Address:
Your answer
Team Manager 2 Cell Phone:
Your answer
Special Consideration Requests:
Team Managers with multiple teams and team members who appear on more than one team/challenge will receive first consideration for scheduling on tournament days. Teams with legitimate scheduling needs (appearance in another event on the same day, for example) will be scheduled to the best of the Tournament Director's ability.
Special Considerations:
Your answer
Release Disclaimer:
Release/Disclaimer By my participation in an event conducted by an Affiliate, Region or other gathering related to the Destination Imagination program, the participant or participant's parents or participant's guardian understands and hereby voluntarily agrees to release, waive, forever discharge, hold harmless, defend and indemnify Destination Imagination, Inc., and their agents, officers, boards, volunteers, and employees from any and all liability and all claims, actions, or losses for bodily injury, property damage, wrongful death, loss of services, or otherwise which may arise out of the participant's participation in activities related to the Destination Imagination event, including travel to and from the event.
Volunteer Information:
We ask that each team provide a volunteer to ensure that the tournaments run smoothly. Tournament assignments are usually 2-3 hours. Please provide a mailing address and email address (volunteer assignments are mailed or emailed depending on the tournament). Assignments will not be scheduled during the team's team challenge performance. Thank you in advance.
Volunteer Name:
Your answer
Volunteer Email Address:
Your answer
Volunteer Cell Phone:
Your answer
Volunteer Street Address:
Your answer
Volunteer City:
Your answer
Volunteer Zip Code:
Your answer
Media Release:
Sanctioned tournament officials and media representatives will be filming/photographing participants and spectators throughout the day. Please notify all team parent/guardians. MN DI will be using photographs and video clips for marketing purposes, including websites. If you have team members who prefer not to have their pictures used, please indicate their names here.
Team members who prefer not to have their pictures used, please indicate their names here:
Your answer
Payment:
After submitting form, please send tournament fee ($150 per team and $50 per Rising Star team) payable to Intermediate District 287 by January 11, 2019 to:
Intermediate District 287
Attn: Kim Kallroos
1820 Xenium Lane N
Plymouth MN 55441

If you want a copy of your registration, please print before you hit the submit button.

If your school requires an invoice, please email Kim with a request.

Questions? Please email Kim at kkkallroos@district287.org or call 763-550-7245. If you do not submit your fee by the January 11th deadline, a $40 per team late fee will apply. Sorry no refunds.

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