Full Name: *

Email Address: *

Phone Number: *

Child Full Name: *

Age: *

Allergies/Medical Considerations: *

Grade Level: *

School Name: *

Child T-Shirt Size: *

I give permission for my child to participate in the Lil’ Innovators event. *

Yes

No

I consent to photos/videos of my child being used for promotional and educational purposes. *

Yes

No

Submit