This form will allow you to register one team at a time for the 6th Western Canada RoboCup Junior Games.

Closing date: October 30th 2011 

* fields are required

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School School Address [independent competitors please supply a School Address] Address City Postal Code School/Independent Student Competitor Contact Contact Name Telephone  Enter a valid phone number. Example: 123-456-7890 Fax  Enter a valid phone number. Example: 123-456-7890 Email  Enter a valid email address. Example: name@company.com Event & Team Details: Event Dance PrimmaryRescue PrimmarySoccer PrimmaryRescue SecondarySoccer Secondary Team Name Garde/Year Level Team Supervisor Students Names (please separate names by commas) Robot Name (optional)