If you are human, leave this field blank.Student InformationFirst Name *Last Name *Gender *MaleFemaleEmail *Full Address: *Home Phone# xxx-xxx-xxxxMobile Phone#: XXX-XXX-XXXX *Date of Birth *School Name *Grade *I plan to participate: *FRCDo you have any experience with (please circle all that apply)AutocadComputer AnimationDesignOtherOtherPARENT(MOM) GUARDIAN 1 INFORMATIONName (First Name & Last Name) *Mobile Phone#: xxx-xxx-xxxx *EmployerEmail *Address (if different from student)PARENT(DAD)/GUARDIAN 2 INFORMATIONName(First name & Last Name) *Mobile Phone#: xxx-xxx-xxxx *EmployerEmail *Address (if different with student)EMERGENCY CONTACT(The person listed as the emergency contact should be someone other than the parent/guardian. They will be contacted in an emergency only if we cannot reach a parent or guardian)Name (First Name & Last Name) *Contact Phone#:xxx-xxx-xxxx *Harris Teeter VIC Card #:Student T-shirt size (adult sizes) *XSSMLXLAllergies? If yes, please provide detailSTUDENT CONTRACT Parents and student must read and agree to the student contract. Please Copy and Paste this Link to your browser.PERMISSION TO PARTICIPATE IN ECG ROBOTICS FTC AND FRC ACTIVITIES *I DOI DO NOTI understand team meeting will be at various facilities.Parent/Guardian Name *Date *PHOTO CONSENT *Parent Consent --please click to open, sign and return I DOI DO NOTParent/Guardian Initials *Student InitialsRegistration Fee$200SubmitCaptcha *reCAPTCHA is required.Submit
