RobocupJunior Canterbury Registration Form
Date: Saturday August 19th, 2017
Entries close: Friday August 4th
Venue: Auroa Centre, Burnside High School.

Please enter all data carefully, and check name spellings.

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

Use your school name as reference.

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
Team member 1 name
Your answer
Team member 2 name
Your answer
Team member 3 name
Your answer
Team member 4 name
Your answer
Team member 5 name ( any prizes may be limited to 4 per team)
Your answer
Team member 6 name ( any prizes may be limited to 4 per team)
Your answer
Team member 7 name ( any prizes may be limited to 4 per team)
Your answer
Teacher / Parent / Team Leader name
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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