2025 MindBlast XR Hackathon School Participation Form
Empowering Students to Innovate, Create, and Solve Real-World Challenges Through Immersive Technology Experiences
EVENT DATE: April 14 - April 18, 2025 EVENT LOCATION: TBD SUBMISSION DEADLINE: February 24, 2025
School Information
Essential Details to Connect and Collaborate with Your School Team
School Name
*
School Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Who is filling out this form?
*
First Name
Last Name
Do you work at the school?
Yes
No
No, but I am a parent
Person's Title/Position
Person's Phone Number
*
Please enter a valid phone number.
Person's Email
*
example@example.com
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Personal Information
This section is for parents who want to sign up their child directly.
Participant's Name
*
First Name
Last Name
Parent/Guardian's Name
*
First Name
Last Name
Relation to the participant
*
Participant's Email
*
example@example.com
Parent's Email
*
example@example.com
Parent's Phone Number
*
Please enter a valid phone number.
Has the child participated in past hackathons?
*
Yes
No
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Team Information
Build Your Team: Share Details About Your Student Participants and Focus Areas
Number of students participating (5 Max)
Grade Levels of Participants (Check all that apply):
Grades 5
Grades 6
Grades 7
Grades 8
Preferred Focus Area for Hackathon (Optional):
Social Justice
Environmental Challenges
Community Engagement
Other
If other, please specify
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Technology Access
Ensuring Your Team Has the Tools and Resources for a Seamless Hackathon Experience
Do you and your team have access to the following (Check all that apply):
*
Laptops or Desktop Computers
High-Speed Internet
Virtual Reality Equipment
Other (Specify): _________________________
If other, please specify
*
Will you and your team require equipment to be loaned for the event?
*
Yes
No
Not for all students
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Supervision and Support
Guidance and Leadership: Supporting Students Throughout the Hackathon Journey
Teacher/Chaperone Name(s): This will be the team's contact person.
*
First Name
Last Name
Contact Person's Phone Number
Please enter a valid phone number.
Contact Person's Email
*
example@example.com
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Logistics
Planning the Details: Transportation, Accommodations, and Special Requirements
Does your team require transportation assistance to the event location?
*
Yes
No
Maybe
Do any of the student participants have any dietary restrictions or special accommodations?
*
Yes
No
If yes, please specify
*
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Participation Fee:
A $500 participation fee is required for each school team to join the MindBlast XR Hackathon. Payment is due upon submission of this form and can be made via check or online payment.For any payment-related inquiries, please contact Juan Rodriguez at juan@wcxr.org.
Participation Confirmation:
As a participant, you are required to attend the following. Check off all boxes if you plan on participating in this year's hackathon.
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Recruit members to be part of your team (5 members per team). It can only be middle school students. You can recruit family members to join.
Attend workshops to learn about the software you'll be using during the hackathon. Keep in mind that some workshops are after-school and/or on Saturday mornings.
Commit to 1-3 hours per day during April Vacation (April 14-18) to learn, design, and build your virtual reality environment.
Attend Presentation Day on April 19, 2025 and present your project with your team.
Be open-minded and respectful about the issues you'll be learning about during the hackathon. These are real issues affecting underserved communities in Rhode Island.
Ask questions when confused or concerned.
Please confirm your school’s intent to participate in the MindBlast XR Hackathon and your understanding of the $500 participation fee requirement. This fee is waived if we have our after-school program at your school.
*
Yes, we understand the $500 participation fee is required, and we are excited to participate! We will submit payment via [Check / Online Payment Portal] along with this form.
No, we will not be participating in the MindBlast XR Hackathon this year.
N/A
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Consent and Agreement
By signing below, you confirm your school’s participation in the MindBlast XR Hackathon and agree to ensure all necessary permissions (e.g., parental consent forms) are obtained for participating students.
Parent or School Administrator’s Name:
*
First Name
Last Name
Signature
*
Date
*
-
Month
-
Day
Year
Date
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Submission Instructions
Please email the completed form to Juan Rodriguez at juan@wcxr.org by Monday, March 10, 2025. For any questions, contact us at 401-497-6988 or 401-328-2602.
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