First Lego League FLL Application and Registration Form 2017

In case of an accident or serious illness, the school will attempt to contact me. If needed, I understand that my child will be transported to the nearest hospital for emergency care treatment. First Lego League (FLL) is a school- sponsored function of Cornerstone for students in Grades 4-8; ages 9-14 as of January 1, 2017. The ideal FLL team member: likes to tinker, discover, and learn how things work; is creative; has fun solving problems; is interested in science, technology, engineering, computers, and robots; is able to stay on task. Meeting Times: Usually Fridays (some Thursdays) after school from 3:15 to 5:00 pm. Occasional practice sessions may be scheduled as needed. Team members are expected to attend most practices and tournaments—we are a team! All children must bring their own snack. Registration Form Parent/Guardian Name:__________________________________ Please print neatly all information. Child’s Name:____________________________ Child’s Birthdate:__________ Current Age: ___ Signature:_______________________________ Date:___________________________________ Parent’s Name:___________________________ In case of emergency, contact (print name and phone number below): _____________________________________ Parent’s Phone Number:___________________ _____________________________________ Email: _________________________________ Identify any medical conditions:_____________ Pick Up Location: Outside under the portico of the Elementary Building; please do not ring the bell to enter as the school office will be closed. Food Allergies:___________________________ _______________________________________ Fee: $75 per students; checks can be written to “CCS” with “FLL” written on the memo line. Who will be picking up your child? ( We will not Location: Elementary Building, CCS Library (Please note that participating students will assemble outside the elementary building office and will be escorted by an adult to the library.) Child’s T-Shirt Size ________________________ release the child to anyone other than the name listed, no exceptions. ) The completed registration form and fee must be submitted to the school office before your child’s application can be considered. The team will be limited to only 10 members, selected on a first-come-first-served basis in the order in which applications are received directly by Mrs. Dawn Snellenberger (elementary office). For more information about FIRST LEGO League, please contact Bob Shemenski at 860-752-8675 _______________________________________ My child, _______________________________, has permission to attend FIRST LEGO League on Fridays, starting September 8, 2017, through December 15, 2017 (tentative end date), from 3:15-5:00 pm. Please note that pick-up must be on time and will be outside under the portico of the Elementary Building. Please note: No medications will be permitted or administered during FIRST LEGO League meetings.