Register for an Event

The 12th Annual DSBN Technological Skills Competition - Be a Champion!
Competitor Registration Form 2010

Please select your school level first:

Level:

Elementary       Secondary

Elementary Level Registration Form:
Competition Name:	Please Select a Challenge 4 and 6 Lego Robotics 7 and 8 Lego Mechanics 7 and 8 Lego Robotics 7 and 8 Technology Challenge 7 and 8 2D Animation
Competitor Name:
Gender:	Female      Male
Your Team Members (If Applicable):
School:	Please Select Your School Alexandra Applewood A K Wigg Battlefield Bertie Burleigh Hill Caistor Central Campden Carleton Central Cherrywood Acres College Street Col John Butler Connaught Crowland Central Crystal Beach Dalewood Dewitt Carter Edith Cavell Empire E. I. McCulley E W Farr Ferndale Fitch Street Forestview Fort Erie Elem. F. J. Rutland Gainsborough Garrison Road Glen Ridge General Vanier Glendale Glynn A. Green Gracefield Gordon Grand Avenue Grapeview Greendale Heximer Avenue Jacob Beam James Morden John Marshall Jordan Kate S. Durdan Lakeview Laura Secord Elem Lincoln Centennial Lockview Maple Grove Martha Cullimore Mathews Maywood McKay Meadowvale Memorial Nelles Oakridge Oakwood Ontario Orchard Park Park Parliament Oak Parnall Pelham Centre Pine Grove Plymouth Port Weller Power Glen Prince of Wales N Prince of Wales S Prince Philip (NF) Prince Philip (SC) Princess Elizabeth Princess Margaret Quaker Road Queen Mary Richmond Street Ridgeway Elem River View Rose Seaton Ross Senator Gibson Sheridan Park Simcoe Street Smith Steele Street Stevensville St Davids Valley Way Victoria Vineland Virgil Westdale Westmount Winger William E Brown Woodland
Science & Technology Centre	Please Select Your S&T Centre E.L. Crossley Fort Erie Grimsby Lakeport/Eden Niagara District Port Colborne Ridgeway-Crystal Beach St. Catharines Collegiate Stamford Collegiate Institute Westpark
Grade:	4 5 6 7 8
Full Name of Teacher:
Student's Address:
City:
Province:
Postal Code:
Home Phone:
Email Address:
Date of Birth:	Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Full Name of Emergency Contact Person:
Relationship:
Emergency Contact Phone:	(daytime) (evening)
In the event that your contest is a recipient of a clothing donation, please indicate clothing size: NOTE: All sizes are in adult sizing
Shirt:	Small Medium Large Extra Large 2X Large
Yellow areas are absolutely required, even for preliminaries. Orange areas are required for medalists.
Medical Information(Please fill out completely):
Provincial Health Card #:
Year of Last Tetanus Shot:
Do you have any medical conditions that would affect your ability to participate?
	No      Yes
If yes, explain:
Do you have special needs (physical, language) that will require additional support at the contest?:
	No      Yes
If yes, describe the need and support required:
Do you have any allergies or dietary restrictions?:
	No      Yes
If yes, please list them:

Secondary Level Registration Form:
Competition Name:	Please Select a Challenge 2D Character Animation Team (2) 3D Character Animation Team (2) Architectural Tech & Design (CAD) Auto Service Technology Baking Carpentry - Individual Carpentry Team of 2 Computer Aided Manufacturing Culinary Arts Desktop Publishing Electrical Wiring Graphic Design Hairstyling Job Interview Challenge Job Skill Demonstration Landscape Gardening Team(2) Mechanical CADD Photography Precision Machining Refrigeration Robotics Team(4) Small Powered Equipment TV/Video Production Team (2) Website Development Welding
Competitor Name:
Gender:	Female      Male
Your Team Members (If Applicable):
School:	Please Select Your School A.N. Myer Secondary Beamsville Eastdale Secondary Eden High E.L. Crossley Secondary Fort Erie Secondary Governor Simcoe Grimsby Secondary Kernahan Park Lakeport Secondary Laura Secord S.S. Niagara District Port Colborne High Ridgeway-Crystal Beach St. Catharines Collegiate Sir Winston Churchill South Lincoln High Stamford Collegiate Thorold Secondary Welland Centennial Westlane Secondary West Park Secondary
Grade:	9 10 11 12 12+
Full Name of Teacher:
Check if you are involved in: (allow for more than one box to be selected)	Related Course CO-OP OYAP PROGRAM
Student's Address:
City:
Province:
Postal Code:
Home Phone:
Email Address:
Date of Birth:	Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Full Name of Emergency Contact Person:
Relationship:
Emergency Contact Phone:	(daytime) (evening)
In the event that your contest is a recipient of a clothing donation, please indicate clothing size:
Shirt:	Small Medium Large Extra Large 2X Large
Waist:	25" 26" 27" 28" 29" 30" 31" 32" 33" 34" 35" 36" 37" 38" 39" 40"
Inseam:	28" 29" 30" 31" 32" 33" 34" 35" 36" 37" 38" 39" 40"
Medical Information (Please fill out completely):
Provincial Health Card #:
Year of Last Tetanus Shot:
Do you have any medical conditions that would affect your ability to participate?:
	No      Yes
If yes, explain:
Do you have special needs (physical, Language) that will require additional support at the contest?:
	No      Yes
If yes, describe the need and support required:
Do you have any allergies or dietary restrictions?:
	No      Yes
If yes, please list them:

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