Team Member Registration Form
This is an application from but payments must be made at time of submission. If we do not have enough space for your child to participate then all fees will be returned.

Membership Fee for the 2019/2020 Season for FRC members is $400 and for FLL members $250.

FRC Members working in the machine shops must provide their own CSA Approved safety footwear.

It is expected that FRC Members will attend at least 65% of scheduled Team Meetings and at least
two outreach activities each season.

FLL registration is closed.
I am interested in joining: *
Student Contact Information:
First Name *
Last Name *
Home Address *
Home Phone *
Cell Phone *
Email *
Grade (as of September) *
School *
Date of Birth *
MM
/
DD
/
YYYY
Languages Spoken *
Emergency Contact Information:
Primary Contact's Name *
Relation to Student *
Primary Contact's Home Phone *
Primary Contact's Cell Phone *
Primary Contact's Email *
Secondary Contact's Name *
Relation to Student *
Secondary Contact's Home Phone *
Secondary Contact's Cell Phone *
Secondary Contact's Email *
Primary Contact's Home Address (if different from student)
Please describe how you can support the team. *
Payment must be made to complete registration. If you have any questions please email niagararobotics@gmail.com.
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