STUDENT INFORMATION First Name* Last Name* GenderMaleFemaleNon-Binary Email* Full Address * Home Phone# (xxx-xxx-xxxx)* Mobile Phone# (xxx-xxx-xxxx)* Date of Birth (MM/DD/YYYY)* School Name* Grade (Fall 2023)* Does this student have food or environmental allergies?YesNo If yes, please list allergies Does the student carry medication?YesNo If yes, what medication? I plan to participate in the following program (choose only one)*FIRST Robotics Competition (FRC)FIRST Tech Challenge (FTC) Do you have any experience with (Please check all that apply)AutocadComputer AnimationGraphic DesignComputer ProgrammingWeb Page DesignElectronicsOther If you've checked "other," please describe: I am interested in (optional):OutreachSponsorship LiaisonMarketingFundraising PARENT(MOM) GUARDIAN 1 INFORMATION Name(First Name & Last Name)* Mobile Phone# (xxx-xxx-xxxx)* Employer Email* Address (if different from student) PARENT(DAD) GUARDIAN 2 INFORMATION Name(First Name & Last Name)* Mobile Phone# (xxx-xxx-xxxx)* Employer Email* Address (if different from student) EMERGENCY CONTACT (The person listed as the emergency contact should be someone other than the parent/guardian. They will be contacted in a emergency only if we cannot reach a parent or guardian) Name (First Name & Last Name)* Contact Phone# (xxx-xxx-xxxx) May we link your VIC card to ECG Robotics?YesNoDo not have a VIC card Harris Teeter VIC Card # Student T-shirt size (adult sizes)XSSMLXL Student Contract Parents and student must read and agree to the student contract. Please Copy and Paste this Link to your browser. PERMISSION TO PARTICIPATE IN ECG ROBOTICS FTC AND FRC ACTIVITIESI DOI DO NOT I understand team meeting will be at various facilities. Parent Consent --please click to open, sign and return Parent agrees to volunteer for at least 15 hoursI DOI DO NOT Parent/Guardian Name* Date (MM/DD/YYYY) PHOTO CONSENTI DOI DO NOT Commitment to 75% attendance policyI DOI DO NOT REQUIRED ESSAY REGARDING YOUR INTEREST IN ECG ROBOTICS (about 200 words)* Parent/Guardian Initials* Student Initials Registration Fee $350 What is the state bird of NC? Δ