Summer Program Registration Form ITKAN and Tawasaw

2025 Registration Application

Tawasaw x ITKAN Silicon Valley Robotics Chapter
Volunteering Parent
Volunteering Parent Name*

First NameLast Name
Parent 1 E-mail*
Volunteering Parent Profession:*
Phone Number:*
Relationship to the Student*

FatherMother
Are you able to-at least-commit to a volunteering role every other session (Biweekly)?*

YesNo
Important: There are multiple areas where you can volunteer, and you can find the descriptions by clicking here

Section 1: Parent Commitment Agreement

As the parent/guardian of a student participating in the Robotics Chapter (FTC/FLL teams), I understand that my involvement and support are essential to my child's experience and to the success of the team. I agree to the following commitments:
Which of the following areas can you volunteer at? (choose all what applies, roles description can be found above)*

FLL CoachingCADBuilding and ManufacturingProgrammingLogistics and AdministrationOutreach and MarketingTarbiya
Classes are held in SBIA on Saturdays between 3PM-7PM, does this time window work for you?*

YesNo
Child(ren) Information
Student 1- Child's Name*

First NameLast Name
Student 1-Birth Date*

MonthDayYear
Student 1- Current Grade *
Gender*

MaleFemale
Student 1-Does the child have previous robotics experience?*

YesNo
Student 1- If your answer is yes to the previous question, can you please provide details on the previous robotics experience:
Student 2- Child's Name

First NameLast Name
Student 2-Birth Date

MonthDayYear
Student 2-Current Grade
Student 2- Gender

MaleFemale
Student 2-Does the child have previous robotics experience?

YesNo
Student 2-Does the child have previous robotics experience?

YesNo
Student 2- If your answer is yes to the previous question, can you please provide details on the previous robotics experience:
Student 2- Does the child have any allergies, chronic illness, or medical conditions? If yes, please describe.
Student 3- Child's Name

First NameLast Name
Student 3-Birth Date

MonthDayYear
Student 3- Current Grade
Student 3- Gender

MaleFemale
Student 3-Does the child have previous robotics experience?

YesNo
Student 3- If your answer is yes to the previous question, can you please provide details on the previous robotics experience:
Student 3- Does the child have any allergies, chronic illness, or medical conditions? If yes, please describe.
Student 4- Child's Name

First NameLast Name
Student 4-Birth Date

MonthDayYear
Student 4- Current Grade
Student 4-Gender

MaleFemale
Student 4-Does the child have previous robotics experience?

YesNo
Student 4- If your answer is yes to the previous question, can you please provide details on the previous robotics experience:
Student 4- Does the child have any allergies, chronic illness, or medical conditions? If yes, please describe.
Will your child(ren) be available for the full duration in the summer without any interruptions (e.g., due to travel)?*

YesNoNot sure yet
Parent 2

First NameLast Name
Parent 2 Cell Number

Area CodePhone Number
Parent 2 E-mail
example@example.com
Emergency Contact
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number *
Relationship to Student?*
Comments/Questions:
Please put any questions, concerns, or comments here:
Should be Empty:

2025 Registration Application

Emergency Contact

Comments/Questions: