TechBrick Robotics: Aberdeen MD

Forms and Registration Information

REGISTRATON is OPEN for ALL PROGRAMS. CLICK HERE FOR INFO.
CLICK HERE FOR FULL PROGRAM INFORMATION
TechBrick Robotics Registration for Students
  1. Enrollment Status(*)

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  2. **********************************************************************************
    Tuition Based Programs
    * JrFLL runs from mid-Sept for about 6 weeks. Then again in January/Feb for events. COST: $75 per student.
    * FLL runs from mid Aug through March. COST: $200 per student.
    * FTC runs from late Aug through March. COST: $250 per student.
    * FRC runs from late August through April with an intensive six week build session from Jan through mid-Feb. COST: $300 per student.
    **********************************************************************************
  3. **********************************************************************************
    Please see the Microsoft Word worksheet for explanations of these items. We suggest you enter information into the worksheet where necessary then copy/paste it into this final application. CLICK HERE FOR THE WORKSHEET. Fields with an * are required.
    **********************************************************************************
  4. Please Choose a Program(*)



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  5. *************************************************************************
    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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  13. *************************************************************************
    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. School Name
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    If not in the list above.
  16. Student's Grade for Next Sept(*)
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  17. Type of School



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  18. *************************************************************************
    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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  24. *************************************************************************
    GUARDIANS
  25. *************************************************************************
    Guardian 1
  26. Relationship to Student(*)




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

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  33. *************************************************************************
    Guardian 2
  34. Relationship to Student




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

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  41. *************************************************************************
    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.
  42. Signature of Guardian 1(*)
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    Enter your name between the slashes.
  43. Signature of Guardian 2
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    Enter your name between the slashes.
  44. *************************************************************************
    INJURY TRAVEL WAIVER

    I authorize TechBrick Robotics and 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.
  45. Signature of Guardian(*)
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    Enter your name between the slashes.
  46. Students Birthday(*)
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    Please enter the date in mm/dd/yyyy format.
  47. *************************************************************************
    COMMITMENT PAY DUES
    *************************************************************************

    Upon acceptance or re-enrollment I agree to pay the dues in full by July 10 preceding the season via invoice from TechBrick.
    * Jr FIRST LEGO League $65
    * FIRST LEGO League $160
    * FIRST Tech Challenge $210
    * FIRST Robotics Competition $275
  48. Signature of Guardian(*)
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    Enter your name between the slashes.
  49. *************************************************************************
    COMMITMENT ATTEND MEETINGS AND ASSIST
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    By Applying for these Programs you are committing to making attendance a priority.
    * Jr FIRST LEGO League: In homes. 6-10 meetings in the fall.
    * FIRST LEGO League: At APG: Every Tues night late August though Jan with some additional practices. Offsite: Same schedule on nights selected by the team.
    * FIRST Tech Challenge: At APG: Every Tues night late August through April with some additional practices. Ongoing meetings after tournament season.
    * FIRST Robotics Competition: Every Tues night late August through April plus 4-6 nights per week during the six weeks of build season (Jan-Feb). Ongoing meetings after tournament season.

    I also understand that each guardian will be expected to volunteer for at least one meeting each year to assist with building access and related administrative tasks on Tuesday nights.

    We agree to make attendance in this program a priority.
  50. Signature of Guardian(*)
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    Enter your name between the slashes.
  51. *************************************************************************
    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.
  52. Signature of Guardian(*)
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    Enter your name between the slashes.
  53. *************************************************************************
    GOALS AND INTEREST
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    Parents please enter two or three short sentences.
  54. Parents: Describe what you would like your son or daughter to gain from this program.(*)
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  55. Students: Describe briefly why you are interested in this program.(*)
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  56. Please Enter the Code(*)
    Please Enter the Code
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