Lexington Destination Imagination 2021-2022 Registration

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Welcome to Lexington Destination Imagination (LexDI)!

We're looking forward to an exciting year with interesting challenges. Please complete one registration form per participating student. Each registration requires: (1) completing and submitting this form and (2) payment of registration fees online. DO NOT FORGET TO CLICK THE "SUBMIT" BUTTON at the end of this form. A copy of the filled form will be sent to the email address provided as confirmation. Visit the "Resources" webpage of www.LexDI.org for more information.

Email *

Contact Information for Primary Parent Contact

Use this section to provide information for the parent who will be our primary contact.

Parent's first name *

Parent's last name *

Street address *

City *

ZIP code *

Primary telephone number *

Student's first name *

Student's last name *

Gender *

Male

Female

Prefer not to say

School *

Bowman

Bridge

Estabrook

Fiske

Harrington

Hastings

Clarke Middle School

Diamond Middle School

Lexington High School

homeschool

Other:

Grade *

Kindergarten

Student T-shirt size *

Child - S

Child - M

Child - L

Adult - S

Adult - M

Adult - L

Adult - XL

Adult - XXL

Team Placement Information

We highly recommend forming your own team with 3-7 students and choosing a team manager (e.g. adult coach). This way your team will be formed immediately.

Please ensure all students in your team are registered. If you have other students in mind to form a team, please talk to them first. We request all team members list other team member names in the following section. If you have a group of students willing to be in the same team and do not have a team manager (TM), please volunteer to be the TM. Team formation cannot be guaranteed without having a TM volunteer.

List full names of students, if you're forming your own team

Provide the Team Manager's name, if you have one.

If you do not have a team, please preview DI challenges (https://www.destinationimagination.org/challenge-program/2021-22-challenge-previews/  ) with your child and indicate his/her top two choices (Please skip Digital Open) -

Technical

Scientific

Fine Arts

Service Learning

Rising Stars (2nd grade or under)

Engineering

Improvizational

Number of prior years of DI experience for the child or parent

Volunteer commitment *

Lexington DI is a volunteer-run program. We require a volunteer commitment from at least one parent of each student participating in the program. Preference is given in team placement to students whose parents volunteer to be a TM or co-manage a team.

As the parent, I offer to be a team manager or co-manager.

As the parent, I offer to help on-going DI meetings and activities.

Required

Comments

If you have comments or further information that will help us process your registration or team formation, please add them here

If volunteering as a team manager, my t-shirt size

Adult - S

Adult - M

Adult - L

Adult - XL

Adult - XXL

Adult - XXXL

Clear selection

Participation commitment *

Please discuss this commitment with your student before agreeing.

We agree that my child will participate the Massachusetts DI tournament in March-April 2022. We trust MADI takes all safety measures under COVID19.

No interference commitment *

The Destination ImagiNation program requires that all Team Challenge solutions be the work of team members. Any assistance with the solution from parents, siblings, classmates, or other people not on the team is considered "interference" and will generally result in a penalty for the team. This includes actual work on the solution, suggestions and ideas that are incorporated in the solution, and any feedback about material that the team is considering or incorporating in the solution (even "that's a really clever solution").

Our family agrees to abide by the "No Interference" rule. We understand that the team will need to report to their appraisers any assistance, ideas or suggestions that they have received from anyone not on the team, and that interference will result in a penalty for the team.

Consent, release and indemnification *

I am parent or guardian with legal custody of the student who is the subject of this registration, who is a minor (my "child"). I have read and understand the description of the Lexington Destination ImagiNation program (the "program") and its rules and parameters on this registration form. In consideration of the opportunity for my child to participate in the program, I hereby consent to (1) my child’s participation in the program, including without limitation meetings, fundraisers, competitions, and town-wide program events, (2) the taking of pictures, videos, and other images of my child during or in connection with any program activities, (3) the use of my child’s name, work, and/or image (including videos) in program activities, in advertising or promoting the program, or for any other program-related purpose, and (4) the provision or authorization of emergency medical or dental care for my child, including hospital treatment, by any program volunteer or coach, should such care become necessary (in the sole and absolute judgment of such volunteer or coach) to preserve or protect the life, limb, health or well-being of my child during the course of any program activity. In the case of such emergency care, I understand that I will be notified as soon as is reasonable possible under the circumstances. I further agree, on behalf of myself and my child, to release, indemnify, and hold harmless the program, its officers, employees, agents, volunteers, and managers, the Lexington Public Schools, Lexington Community Education, any PTA, PTO, PTSA, or JCSA, and any person or entity hosting any program activities, from any and all liability, claims, damages or expenses arising directly or indirectly out of any incident involving, or on account of any injury to, my child in connection with the program.

Required

Pay registration, enter order confirmation number and submit the form

The registration fee is $125. It covers LexDI T-shirt, the DI team registration and Massachusetts tournament fee. Team manager may collect additional and up to ~$25 for supplies after the teams are formed.

Note: Starting on Monday Nov 15, 2021, we soft close our registration. We will still take your child's information, and we will try hard to place your child to a team. If we successfully place your child, you will get a private payment link to pay the registration fee.

Do not FORGET to SUBMIT this form TO COMPLETE the registration.

Enter payment order number or receipt number here

Note: Please fill TBD here, until you receive payment link privately. Once you finish the checkout, you should see the "order details" confirmation page. Please paste the 5-digit order number on the top of the page, and click SUBMIT below. You can also place 8 digit receipt number received from email confirmation.

A copy of your responses will be emailed to the address you provided.

Submit

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