RobocupJunior Nationals Team Registration Form
Date: September 16th 2017
Venue: Dunedin City Baptist Church, Main South Road, Dunedin.

Please enter all data carefully, and check name spellings.

All entries require a team entry fee of $40 to be paid. The Robotics Education NZ Trust account number is
123150-0211595-00
The trust is not registered for GST.

Use your school name or team name as reference.

NOTE that there will be Digital Technology workshops on Friday September 15th, 9am-3pm, at University of Otago and Otago Polytech for visiting students. Arrive a day early and participate in these if you can. There is a $10 charge for the day to cover lunch.

What is your RobocupJunior team's name ?
Your answer
Which event are you entering (choose from the drop-down list)
School Name
Your answer
School Street Address and Town/City
Your answer
Member 1 name
Your answer
Member 2 name
Your answer
Member 3 name
Your answer
Member 4 name
Your answer
Member 5 name (any prizes may be limited to 4 per team)
Your answer
Member 6 name (any prizes may be limited to 4 per team)
Your answer
Member 7 name (any prizes may be limited to 4 per team)
Your answer
Teacher/parent/team leader contact name for team
Your answer
Contact cell phone for team
Your answer
Contact email for team (all information will be sent to this address)
Your answer
List any other contact emails below
Your answer
Submit
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