UHSSE Robotics Team 1991 - Student Registration Form

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2020-21 season signup

Student Last Name *

First Name *

Cell Phone Number *

Student Email Address *

Grade *

9th

10th

11th

12th

Gender *

Female

Male

Non-binary

Ethnicity *

African American or Black

Asian and Pacific American Islander

Hispanic or Latino

White or Caucasian

Other:

Age *

Home town (this can help with carpooling) *

Parent/Guardian 1 - Full Name *

Parent/Guardian 2 - Full Name

Parent/Guardian 1 - Email Address *

Parent/Guardian 2 - Email Address

Parent Cell Phone Number / Emergency Contact *

Will parent volunteer to help the team? If so, in what capacity? *

Parent contacts and town listed in a directory (only distributed to the team)? *

Yes

Paid $40 dues? (Check sent to robotics team at school address, or by credit card using donation button on team website, www.team1991.com) *

Yes

Completed health form (sending form by email)? *

Yes

Size for Team T-Shirt? (Included registration fee) *

XXL

Parent 1 Place of Employment (can help with sponsorships)

Parent 2 Place of Employment

I authorize my child to participate in the UHSSE FIRST Robotics 4-H Team 1991 this year (type parent/guardian name) *

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