Lord of the Bricks Team Signup Form
Share your contact details, your child’s information, and your team interests for Pierian Spring Foundation.
Parent/Guardian 1 Information
Full Name
*
First Name
Last Name
Relationship to Child
*
Please Select
Parent
Guardian
Grandparent
Other
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian 2 Information
Full Name
First Name
Last Name
Relationship to Child
Please Select
Parent
Guardian
Grandparent
Other
Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Child Information
Child's Full Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Team Interest
*
FTC 7039 — ages 11+ (middle & high school)
FLL Challenge 9076 — ages 9-14
FLL Explore 933 (Explorers) — ages 5-8
Not sure — please advise
Areas of Interest
Programming / Coding
Robot Building / Mechanical
Electrical / Wiring
Design / CAD
Driving / Competition
Notebook / Documentation
Outreach / Marketing
Fundraising
Allergies
Please list all allergies.
*
No known allergies
No known allergies
Parent Notes
Office Use Only
Status
Please Select
Pending
Accepted
Rejected
Internal Notes
Submit Application
Should be Empty: