Registration for 2nd Annual LEGO Contest and Exhibit sponsored by the Bixby Memorial Library and the Boys and Girls Club of Greater Vergennes

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Please complete the full registration form. Each member of a team must submit a complete registration form. Remember only 60 applicants will be accepted - First Come, First served. You will be notified by email if you are accepted into the contest.

Name *

Category *

Pre-K

Grades K-2

Grades 3-5

Grades 6-8

Grades 9-12

Adult

Senior (60+)

Adult/Child Team or Senior/Child Team

Mixed Grade Team (maximum 5 people per team)

Email - please use the email address that we can notify you of your acceptance in the contest. Only 60 constructions will be accepted - First Come, First Served *

Mailing Address *

Phone *

Check One *

This is a team creation

This is an individual creation

I understand that as a participant in this contest photographs may be taken of me and/or my entry to be used in publicity and documentation of this event. I grant to the Bixby Library and the Boys & Girls Club of Greater Vergennes, for the purpose of promoting the Library and the Club and its programs and services, permission to use or make available to others my likeness, comments and/or other expressions in connection with the event and exhibit. I understand and accept that the Bixby Library and the Boys & Girls Club are not responsible for any damage to or loss of my personal property that may occur in connection with my involvement in this event and exhibit. *

Check here if you agree to the above terms

Name of participant (or parent/guardian for participants under 18) *

Date *

YYYY

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