VRC Official Team ID Plates * Qty: 

Official Team ID Plates (4-pack)   +$ 0.00

VRC Clean Sweep Welcome Kit * Qty: 

VRC 2009-2010 Team Welcome Kit (275-1400)   +$ 0.00

VRC Team Registration * Qty: 

VRC Team Registration (RE-VRC-REG-2010)   +$ 0.00

Requested Team Number (enter NONE if you want one assigned) *

Reason for requesting team number

Add letter A? (i.e. 1234A) Additional teams are given a the same team number plus a letter (B, C, D ...) *

• No
• Yes

Team Name *

Robot Name

Primary Contact Name (Adult) *

Primary Contact Phone Number *

Primary Contact Alternate Phone Number

Primary Contact E-Mail Address *

Primary Contact Alternate E-Mail

Secondary Contact: Name (Adult)

Secondary Contact: Phone Number

Secondary Contact: Alternate Phone Number

Secondary Contact: E-Mail

Secondary Contact: Alternate E-Mail

School/Organization *

Address *

City *

Country *

State/Province

Zip/Postal Code *

Have you competed in VEX Competitions before? *

• No
• Yes

Grade range of most students on the team *

-- Please Select --High School Middle School Elementary School College

Estimated number of students on team

Special Needs

Team Sponsor

* Required Fields