TechBrickEducationLogoFull v01 01 300  Registration and Information

TechBrick Education Registration for Students
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    YOU MAY NOW REGISTER FOR THE 2019-20 SEASON. PREFERENCE GOES TO ALUMNI, THEN NEW REGISTRANTS. NEW REGISTRANTS WILL BE TAKEN IN ORDER OF SUBMISSION.

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  2. Enrollment Status(*)

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    Tuition Based Programs

    * JrFLL build season runs from mid-Sept for six weeks. Then has January/February competition events. Registration Fee: $75 per student.
     

    * FLL build and competition season runs from mid-August through March. Registration Fee: $200 per student.
     

    * FTC build and competition season runs from late August through March. Weekly meetings continue throughout the year with off season challenges. Registration Fee: $250 per student before September 1st , $300 thereafter.
    NOTE: Acceptance into the FTC program will be finalized after in-person interview and requires one adult or parent to commit as a mentor/volunteer.  

    * FRC runs from late August through April with an intensive six week build season from Jan through mid-February. Competition season is March and April. Off season events are held in the summer. Weekly meetings continue throughout the year. Registration Fee: $300 per student before September 1 , $350 thereafter.


    Students should not be denied the opportunity to participate because of financial need. Please contact TechBrick at members@techbrick.com for more details.

    You will receive an invoice via email from members@techbrick.com for your child's tuition. We are asking that all dues be paid in full by July 31, 2019 unless other arrangements are made. If you have a special circumstance, please send an email to members@techbrick.com describing your needs.

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    Registration is closed for FLLJr, and FLL. If you are interested in these programs please send an email to marco@techbrick.com. Be sure to include your name and phone and statement of interest.

  4. Please Choose a Program(*)

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    STUDENT INFO
  6. Student First Name(*)
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  7. Student Last Name(*)
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  8. Student Email (if applicable)
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  9. Student Cell Phone (if applicable)
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  10. Gender(*)

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  11. Students Birthday(*)
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    Please enter the date in mm/dd/yyyy format.
  12. Student's Shirt Size(*)
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    SCHOOL INFORMATION
  14. Student's School
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    If your school is not in the list choose "OTHER" and enter your school name below.
  15. If you choose Other please enter your school name
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    If not in the list above.
  16. Student's Grade for Sept 2019(*)
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  17. Type of School



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    HOME ADDRESS
  19. Address 1(*)
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  20. Address 2
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  21. City(*)
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  22. State(*)
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  23. Zip(*)
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    NON PARTICIPATING DAYS
    This is based on personal or religious preferences and DOES NOT include conflicts with other activities.
  25. Please indicate days you cannot participate in practice or events.(*)







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    GUARDIANS
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    Guardian 1
  28. Relationship to Student(*)




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  29. Guardian 1 First Name(*)
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  30. Guardian 1 Last Name(*)
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  31. Guardian 1 Email(*)
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  32. Guardian 1 Best Phone(*)
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  33. Guardian 1 Employer
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  34. Guardian 1: Are you an emergency contact?

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    Guardian 2
  36. Relationship to Student




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  37. Guardian 2 First Name
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  38. Guardian 2 Last Name
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  39. Guardian 2 Email
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  40. Guardian 2 Best Phone
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  41. Guardian 2 Employer
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  42. Guardian 2: Are you an emergency contact?

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    YOUTH PROTECTION

    US FIRST and TechBrick are participating in a comprehensive Youth Protection Program. As a parent of a student in our program you will be asked to review basic youth protection training (no more than 45 minutes) and apply for a basic background check (no fee). For more information see: http://www.usfirst.org/aboutus/youth-protection-program

    I agree to participate in this program as a pre-requisite for my student’s participation. I also commit to informing any adult who wishes to assist with my student's team that they will also need to complete the Youth Protection Program.
  44. Signature of Guardian 1(*)
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    Enter your name between the slashes.
  45. Signature of Guardian 2
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    Enter your name between the slashes.
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    INJURY TRAVEL WAIVER

    I authorize TechBrick Education, its mentors and leaders to supervise my child/children from and provide transportation to various events and functions. Further, I authorize emergency medical decisions to be made on my behalf if the authorized emergency contacts cannot be reached. Participant (and the Parent/Guardian of a Participant under 18 years of age) understands that participation in the Program will expose Participant to risks of injury including, without limitation, injury from: building, lifting, and using electrical/mechanical robots and robot components; using tools; other participants; dancing and other associated activities. Participant, if 18 years of age or older, acknowledges and agrees that he/she is primarily responsible for his/her safety. The Parent/Guardian of a Participant under 18 years of age acknowledges and agrees that the Parent/Guardian is primarily responsible for the Participant's safety and that the Parent/Guardian will monitor, as appropriate considering the age of the Participant and other factors, the Participant's participation in the Program. In consideration for TechBrick allowing the Participant to participate in a Program, Participant (and the Parent/Guardian of a Participant under 18 years of age for and on behalf of the Participant and the Parent/Guardian) assumes all risk of such participation and hereby releases TechBrick and (except as expressly provided below) all of TechBrick's directors, officers, employees, volunteers, and agents from any and all claims for any injury of any kind to the Participant (and the Parent/Guardian) or other damages that may occur as a result of the Participant's participation in the Program, including without limitation any injuries or other damages that may be caused by the negligence of TechBrick or negligence of any of TechBrick's directors, officers, employees, volunteers, or agents (including without limitation negligently failing to adequately investigate or screen coaches, mentors, volunteers, etc.), and agrees not to file any lawsuit or otherwise make any claim against TechBrick or any of TechBrick's directors, officers, employees, volunteers, or agents for any such injury or other damages. The Participant (and the Parent/Guardian of a Participant under 18 years of age) does not hereby release any claims against any individual person who intentionally causes injury to the Participant.
  47. Signature of Guardian(*)
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    Enter your name between the slashes.
  48. Students Birthday(*)
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    Please enter the date in mm/dd/yyyy format.
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    COMMITMENT PAY DUES
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    Upon acceptance or re-enrollment I agree to pay the dues in full by July 31 preceding the season via invoice from TechBrick.
  50. Signature of Guardian(*)
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    Enter your name between the slashes.
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    COMMITMENT ATTEND MEETINGS AND VOLUNTEERING
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    By Applying for these Programs you are committing to making attendance a priority.

    These programs rely on many hours of volunteer time. The FTC and FRC Programs require substantially more volunteer time to perform. By signing this agreement, I agree to help facilitate the program by volunteering to help. TechBrick Education's delivery of these STEM programs rely on our mentors to donate many hundreds of hours each year. By signing your child up for these activities and signing this agreement, you agree to help facilitate the program by volunteering to help in roles that will be assigned in the early fall. Further, you agree that your child will only get out of the program what they put into it - please treat this program like you would a 'varsity' sport. While we aim to have fun while we are learning, missing meetings imposes extra challenges on your child and our mentors & volunteers.

    We agree to make attendance in this program a priority.
  52. Signature of Guardian(*)
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    Enter your name between the slashes.
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    ACKNOWLEDGEMENT OF ADDITIONAL FEES
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    Some events, particularly those including travel, may require additional fees beyond the dues. This is particularly true for the World Championships. Local events may incur food costs and minor travel expenses. These amount vary depending on the event and the level of fund raising.

    We acknowledge that there may be additional events and fees throughout the year which we may choose to participate in or not based on our student’s schedule.
  54. Signature of Guardian(*)
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    Enter your name between the slashes.
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    GOALS AND INTEREST
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    Parents please enter two or three short sentences.
  56. Parents: Describe what you would like your son or daughter to gain from this program.(*)
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  57. Students: Describe briefly why you are interested in this program.(*)
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    CITIZENSHIP
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    We have to make special arrangements for foreign nationals. Please indicate your US citizenship status. If you are not a United States citizen please enter your country of citizenship.
  59. Are you a United States Citizen
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  60. If you are not a US citizen, please enter your country of citizenship.
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