Team Registration Form Otago RobocupJunior 2018

Date: Saturday June 23, 2018
Entries close: Friday June 8
Venue: Dunedin City Baptist Church, Main South Road, Concord, Dunedin

Please enter all data carefully, and CHECK NAME SPELLINGS and capitalisation.

All entries require a team entry fee of $40 to be paid. An invoice will be sent by email in response to this registration.
The Robocup Junior Otago account number is
ANZ 010102-0985453-00
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
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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