Fillable FIRST Robotics Competition (FRC) Team Agreement For (Girl Scouts of Eastern Missouri)

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FIRST Robotics Competition (FRC) Team Agreement For (Girl Scouts of Eastern Missouri)

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LKD
6/3/2020
Team Agreement
For
FIRST
®
Robotics Competition (FRC)
Girl Scouts of Eastern Missouri Inc. is pleased to offer the opportunity for girls to participate in the
FIRST® Robotics Competition during the 2020-2021 season.
The Coach, as named in this Agreement, acting on behalf of the Team agrees to the following. Please
initial each applicable item on the next page, provide the contact information requested, and return
original copy to Girl Scouts of Eastern Missouri.
____ We understand that we are an official Girl Scout Troop and are aware of Girl Scout Troop
requirements, such as participating in the Cookie Program.
____ We understand that we are required to attend a competition, either an Expo or Qualifier,
and that failure to do so will result in a $100 fine.
____ We understand that if we do not continue with the program it is our responsibility to
return the equipment to Girl Scouts of Eastern Missouri.
____ We understand the main season of the FRC program runs November 2020 through April 2021.
____ We understand that the season may be extended through the World Championships, in April
2021, should our team advance to that level.
____ We agree to provide a secure location for team equipment to be stored until it is returned to Girl
Scouts.
____ We agree to return all team equipment to Girl Scouts upon completion of the program.
Equipment may include:
Computer notebook, serial number ___________________________
Notebook mouse, serial number ______________________________
Robot kit
Software
Computer notebook carrying case
____ We agree to keep equipment clean and in good condition for the duration of the program and to
use it only in the manner in which it is intended for this program. Robot kit pieces must be
organized separately and returned to Girl Scouts in an organized fashion.
____ We agree to provide the following girl / adult ratio for each team:
Two adults to every 30 girls in grades 9-12, plus one additional adult to each additional 15 girls.
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6/3/2020
____ We agree that during team meetings, at least one of the adults present is an adult female who is
not related to the other adult.
____ We agree to have any adult working with the team complete the Girl Scouts of Eastern Missouri
volunteer application process, which includes authorization for a background screening to be
conducted through Girl Scouts and its acting agencies.
____ We agree Girl Scouts of Eastern Missouri will provide team t-shirts with appropriate sponsor
logos for up to thirty-five girls and two coaches.
____ We agree to attend the Kickoff event and/or the Coaches Celebration.
____ We agree to provide all paperwork by stated deadlines, including, but not limited to surveys,
amount of time spent on project, photo releases and photos.
____ We agree to notify the Girl Scout Robotics Program Manager in a timely manner if significant
delays or setbacks occur.
____ We understand that our team is required to participate in a FRC Regional Tournament, regardless
of how far the team has progressed.
____ We agree to submit digital photos of girls and adults engaged in the program activities by April 16,
2021.
____ We agree to work with Girl Scouts Communications Department on any team publicity.
____ We understand that if we receive the 2020-2021 FIRST Robotics Competition Grant(s)
Girl Scouts will contribute $3,000 for the Rookie year and $3,000 for the Second year,
and so on.
____ We understand our team will be asked to volunteer at promotional events Girl Scouts hosts, and
we are willing to help out as much as we can.
____ We agree to clearly identify ourselves as Girl Scouts in any recruitment event, media event, or
competition and abide by Girl Scout troop trip guidelines if traveling outside the Council
boundaries.
____ We agree to maintain at least ten girls on our team.
____ We agree to participate in at least two outreach activities that will reach an additional 50 youth
(examples include school presentations or neighborhood demonstration), in order to share my
team’s accomplishments and the benefits of participating in robotics.
USFIRST has set out a Youth Protection Program. Part of this program requires at least two
adults working with robotics teams to be screened through USFIRST’s system. This must be
done before the team can be fully registered and active.
____ We agree that the two adult coaches will comply with the USFIRST Youth Protection Program.
LKD
6/3/2020
Coach Signature ______________________________________________________________
Date _________________
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LKD
6/3/2020
Groups of Girl Scouts interested in competing in the FIRST® Robotics Challenge (FRC) program for the 2020-2021
season should complete the form below and return, by July 3rd, to:
Lauren Kornegay Dollar
Girl Scouts of Eastern Missouri
2300 Ball Drive
St. Louis, MO 63146
lkornegay-dollar@girlscoutsem.org
314-214-3044 fax
314-592-2376
Support is awarded on first-come, first-served basis until all available positions have been filled or the
deadline passes.
Team Name: ________________________________________________________
Adult Coach (does not have to be troop leader, must be/become registered Girl Scout)
Name __________________________________________________________________
Address ________________________________________________________________
City _______________________________ State _____ Zip ______________
Day Phone ____________________________ Evening Phone ____________________
Adult E-mail _____________________________________________________________
Ethnicity ______________________________ Currently registered (Y/N) _________
Troop _________________ District/Neighborhood _______________
Additional Adult (cannot be spouse of coach, must be/become registered Girl Scout)
Name __________________________________________________________________
Address ________________________________________________________________
City _______________________________ State _____ Zip ______________
Day Phone ____________________________ Evening Phone ____________________
Adult E-mail _____________________________________________________________
Ethnicity ______________________________ Currently registered (Y/N) __________
Troop _________________ District/Neighborhood _____________
LKD
6/3/2020
Team Members (Attach an additional page to list more girls)
Girl Name and Address
2020-2021
Grade School Troop
Email
Phone
Number
Race/Ethnicity
1
2
3
4
5
6
7
8
9
10
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6/3/2020
Disability Information
Girl Scouts of Eastern Missouri welcomes the participation of all girls and adults and will make reasonable
accommodations to persons with disabilities. To help Girl Scouts of Eastern Missouri better serve your child,
please indicate whether the participant is in need of a reasonable accommodation in order to fully participate in
the program. The Program Manager will contact you to answer questions and discuss accommodation requests.
You can also contact the Answer Center directly at 314.400.4600 or answercenter@girlscoutsem.org
.
Do you need a reasonable accommodation? _____Yes _____No
Girl Scouts of Eastern Missouri receives grants to support girl robotics programs. As funding is finite, Girl Scouts
of Eastern Missouri is only able to support a certain number of teams for the 2020-2021 Season. Funds will be
allocated on a first-come, first-served basis. Teams will be notified in July if they are funded.
Coach Signature ______________________________________________________________
Date _________________
For Office Use Only
Date Application Received ________________
Name of staff approving ___________________________________________________
Signature of staff approving _________________________________________________
Date __________
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FIRST Robotics Competition (FRC) Team Agreement For (Girl Scouts of Eastern Missouri)

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Completed 9 May 2021

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