First Lego League Explore (FLL), Individual Team Membership, Cargo Connect Theme, 1st- 4th grades

$40.00

The FLL Explore Program (using Lego WeDo robots).

Child 1 Registration Info *REQUIRED*

If completing this form for just 1 child just complete this section. If you are registering more than one student, please complete at least the required information for each.

Student's first and last name

Student's date of birth (month / date/ year)

Student's primary place of residence. Street, unit number (if applicable), city, state, zip code.

Type "same as above" if same as home address. PO boxes are acceptable for mailing address.

Student's Phone Number. May be a cell phone, home phone.

Student's email address. May be a parent's email address if the student doesn't have one.

Student's legal guardian's name

Type "same as above" if same as student's information above. If different: please include street, unit number (if applicable), city, state, zip code. P.O. Boxes are acceptable.

Type "same as above" if same as student's phone number above.

Guardian's primary place of residence. Type "same as student's" if applicable. IF same as student's please just indicate "same as student", If different, please include: street, unit number (if applicable), city, state, zip code.

Name, relationship, phone number (more than one if possible), of who we should contact in case of emergency.

Please list any allergies your child has and the reactions to those allergies.

Does your child have an EpiPen? If so, are they able to administer it themselves?

Are there any special accommodations needed for your child?

Child 2 Registration Info

Leave blank if you're only registering 1 child.

Second student's first and last name

Second student's date of birth (month / date/ year)

If same as student 1: simply type "same" If different than student 1: this is the student's primary place of residence. Street, unit number (if applicable), city, state, zip code.

You may indicate this is the same as student 1 and/or same as home address above. PO boxes are acceptable for mailing address.

Student's Phone Number. If same as student 1: simply type "same"

Student's email address. If same as student 1: simply type "same"

Student's legal guardian's name If same as student 1: simply type "same"

You may indicate this is the same as student 1's guardian and/or same as student's address above.

Guardian's phone number. You may indicate this is the same as student 1's and/or same as student's address above.

Guardian's phone number. You may indicate this is the same as student 1's and/or same as student's address above.

If same as student 1 simply type "same" If different than student 1 please include: name, relationship, phone number (more than one if possible), of who we should contact in case of emergency.

Child 3 Registration Info

Leave blank if you're only registering 1 child.

Student's first and last name

Student's date of birth (month / date/ year)

If same as another student : simply type "same as (# or name)"

If same as another student : simply type "same as (# or name)"

If same as another student : simply type "same as (# or name)"

If same as another student : simply type "same as (# or name)"

Student's legal guardian's name. If same as another student : simply type "same as (# or name)"

If same as another student : simply type "same as (# or name)"

Guardian's phone number. You may indicate this is the same as another student.

Guardian's phone number. You may indicate this is the same as student 1's and/or same as another student.

Whom we should contact in case of an emergency with this student. Please include a method to contact them.

Release and Waiver of Liability and Hold Harmless Agreement - This one section is for every student you are registering on this page

PLEASE READ CAREFULLY. THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS.

Initials

Initials

Initials

Initials

Initials

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Description

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FIRST LEGO League gives elementary and middle school students and their adult coaches the opportunity to work and create together to solve a common problem. Challenged to research a real-world problem, then create an original solution for that problem.

Each year a theme relevant to the world around them is chosen as a focus for the children’s work.

The teams research the topic, displaying their ideas on a team poster, build a LEGO® model and program one part to move using LEGO® Education WeDo 2.0 software.

FIRST® LEGO® League Explore rapidly develops teamwork, design, programming and communication skills, but the most important thing is that it is great fun and makes the children feel proud of what they have achieved!

Note: You need to fill out one form per child, so if you are registering three children, you need to fill out three forms.

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