Grand Rapids Junior Robotics

VEX High School Registration Form

– registration closes August 30 at 10pm

 

VEX Robotics – 2018 Challenge Theme: TURNING POINT

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Participant Information

First Name

Last Name

School

Other School Name

Grade

Date of birth (YYYY-MM-DD)

Age

Gender
MF

T-shirt size

Street Address

City

State
Michigan

Zip Code

 

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Parent's/Guardian's name

Phone Number

Alternate Phone Number

Email address

 
 

Parent's/Guardian's name

Phone Number

Alternate Phone Number

Email address

 

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Emergency Contact

In the event of an emergency, please contact (if parents are unavailable):
 

Name

Primary Phone Number

Secondary Phone Number

 

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Contact me about the following opportunities with GR Jr. Robotics:

Additional Information: