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									                        Lovinggood Middle School

              LEGO® Building Competition
    Enter for a chance to win the LEGO® Star Wars™ DEATH STAR™ set
                  valued at $400, plus other LEGO® prizes!

Date:                    Friday, February 10, 2012
Check in Time:           4:45 p.m. - 5:50 p.m.
Competition Time:        6:00 p.m.
Location:                Lovinggood Middle School
                         (3825 Luther Ward Road, Powder Springs, GA 30127)

Event Description
5th, 6th, 7th and 8th grade students are invited to enter the Lovinggood Middle School
LEGO® Building Competition. A limited number of LEGO® builders, 50 from each
grade level, will display their speed and accuracy to win the DEATH STAR™ and
other exciting prizes. Each entrant will receive a basic LEGO® set for the first level of
competition. The first three builders in each grade level that accurately complete the
assigned set will advance to a final round of timed competition to win the LEGO®
Star Wars™ DEATH STAR™. The fourth, fifth and sixth place builders will compete
in a final round of timed competition to win the LEGO® Star Wars™ MILLENNIUM

The grand Prize is the LEGO® Star Wars™ DEATH STAR™. Door prizes consisting of
LEGO® sets and games will be awarded throughout the competition. All LEGO® sets
used during the competition will become the property of the entrant.

A $40.00 non-refundable entry fee is due with the registration form. The second child
from the same family may register for $30.00 and the third child from the same
family may register for $20.00. Registration on event day will be $50.00 for all

Contest Director:
Mark Justice, Cobb EMC
Lovinggood Middle School                                                    LEGO® Building Competition
3825 Luther Ward Road                                                                Registration Form
Powder Springs, GA 30127


You may register by dropping off the form in person at the front desk at Lovinggood Middle School,
faxing it to 678-331-3015, or mailing it to Lovinggood at the address above.

_____________________________________________________________________________              Cost     $40.00
Child 1: Last name, First name               Initial                    Grade

_____________________________________________________________________________              Cost     $30.00
Child 2: Last name, First name               Initial                    Grade

_____________________________________________________________________________              Cost     $20.00
Child 3: Last name, First name               Initial                    Grade

_____________________________________________________________________________              TOTAL DUE: $ _________
Parent’s Name                                Parent’s Email
                                                                                           (Provide Payment Info Below)

Street Address

City, State, ZIP                                       Parent’s Phone

_____ Check (Made payable to Lovinggood Middle School)                          _____ Cash( must bring to school)
Registering for this event acknowledges acceptance of the following releases by parent/guardian for the minor
student and the family: In consideration for acceptance of this entry, I hereby for myself, my heirs, executors and
administrators waive and release any and all rights and claims for damages I may have against the Lovinggood
Robotics Team, the competition directors, volunteers, representatives, assigns or sponsors for any and all injuries,
damages and/or claims of any description which might arise out of the LEGO® Building Competition and all activities
in any way connected therewith. I understand the building of each LEGO® set will be timed and judged for accuracy. I
attest that I understand and agree that the decisions of the event judges are final. I understand that Lovinggood Middle
School and Cobb EMC reserve the right to use photos and videos taken during the event for news releases, websites,
yearbooks, videos, slide presentations, and all other marketing purposes. Furthermore, I attest that I am currently a 5 th,
6th, 7th or 8th grade student for the school year of 2011/2012.

Participant: _____________________________________________________________             Date __________________________

Parent/Guardian: _______________________________________________________               Date __________________________
                       *A Parent/Guardian must sign for the minor(s)

This event is sponsored by COBB EMC.
All proceeds will benefit Lovinggood Middle School & Wheeler High School Robotics.

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