TAME Club Registration Form

"*" indicates required fields

Step 1 of 4

25%

TAME CLUB: 2023-2024 ANNUAL REGISTRATION

Adult Club Leader - Person completing this form and primary point of contact; supervising liaison who recruits and registers the club and students, hosts the meeting and organizes and facilitates activities during TAME Club meetings and events

Adult Co-Leader (optional) - additional point of contact; helps with recruitment, registration, planning, activities, etc.

CLUB TYPE: SELECT ONE OF THE FOLLOWING ONLY

Club Type*

Texas School

Community Organization - (Engineering service organization like NSBE Jr., IEEE, Scouting, 4H, etc.)

Unaffiliated - (Group of students not affiliated with any school or community organization.)

School/Organization Name or Club Name for Unaffiliated Club*

The name of the school or community group, such as "Gonzalez High School" or "Girl Scout Troup 123." If you are not affiliated with a school or organization, use a descriptive name for your club that your students will recognize.

TAME Club Name

Create a TAME Club name to identify your group.

ADULT LEADER INFORMATION

Adult Leader First Name*

Adult Leader Last Name*

Preferred name for nametags

Salutation*

How do you pronounce your name?

What are your pronouns?

Leader email*

Alternate email

Backup in case of issues with school firewalls.

Leader work phone*

Cell phone*

T-Shirt Size*

Gender identity - Do you think of yourself as:*

Please specify additional gender

Are you Hispanic or Latino?*

Yes

Prefer not to answer

What is your race?*

Check all that apply.

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Additional

Prefer not to answer

Ethnicity: Additional*

Is this your first time sponsoring a TAME Club?*

Yes

Dietary needs*

Check all that apply.

None

Vegetarian

Gluten-free

Vegan

Dairy-free

Other

Dietary (other)*

Please describe your dietary needs.

CLUB INFORMATION

TAME Region/TEA Region*

School District*

Include the name of your school district.

Is your club at a Title I School?*

Yes

To be considered a Title I school, a minimum of 40% of the students must qualify for free or reduced lunch. You can check the status of your school using this link.

List the name of my Club on my Region page of the TAME website?*

Yes

Registered TAME Clubs have the choice to be listed on your Region page of the website to help students, parents, and local partners know how TAME is present in a community. This listing will show the name of your school or organization. It will not show any other identifying data and is optional.

Is this TAME Club new, or renewing?*

New

Renewing

Does your club have additional adult leaders? If so, you'll be able to register them once your Club Registration is complete.*

Yes

Building*

Name of building where you meet.

Street Address*

Address 2

City*

State / Province*

State

ZIP Code*

Ship my toolkit to*

the address provided above

a different address

Name of building

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Is this a residential address?*

yes

For my toolkit, I would prefer a gift card from*

Amazon

Walmart

LEADER CERTIFICATION

Please check to confirm that you understand and agree to the following requirements for your TAME Club:*

My TAME Club will recruit at least 8 student participants.

All participants in my club are in grades 6 – 12

If my TAME Club is not located at a Title I school, I will recruit students so that at least 60% of students members are from TAME focus student groups.

I will coordinate regular meetings about engineering topics for my club members.

I will provide my students with the registration link and have them register online.

By signing below I affirm that all of the above statements are true and that my group is eligible to register as a TAME Club. I understand that TAME can cancel my membership at any time if it is determined that my group is ineligible.

Release: I will participate in TAME Club Events, the Regional Competition and, if selected, the TAME State Competition (collectively, “TAME Events”). THEREFORE, FOR (I) MYSELF; (II) MY LEGAL REPRESENTATIVES; AND (III) MY HEIRS AND ASSIGNS; I HEREBY RELEASE AND FOREVER DISCHARGE TAME, ITS SPONSORSHIP PARTNERS OR OTHER EVENT SPONSORS, THEIR MEMBERS, DIRECTORS, MANAGERS, OFFICERS, AGENTS, AND/OR EMPLOYEES (THE “RELEASEES”), OF AND FROM ANY AND EVERY CLAIM, DEMAND, DAMAGE, INJURY, OR CAUSE OR RIGHT OF ACTION OF WHATEVER KIND OR NATURE EITHER IN LAW OR EQUITY, ARISING FROM ACCESS TO AND PARTICIPATION IN THE TAME EVENTS, EVEN IF CAUSED BY THE NEGLIGENT ACT OR OMISSION OF THE RELEASEES. Photography: I grant permission for TAME, designated TAME representatives, and TAME partners or sponsors to use any photos, film, or videos of me, or my likeness, and any quotes or statements given by me, orally or in writing, without restrictions, in any media, in legitimate accounts and promotions of this event.

I hereby certify that I am at least 18 years old and give this waiver and release freely and knowingly with full understanding of its content and effect. Furthermore, I release full understanding of its content and effect.

Date

MM slash DD slash YYYY

Signature*

Hidden

Accessibility Needs

Yes

Hidden

Please describe your needs

Hidden

Specify school type

Hidden

Mailing address (if different from meeting location - Toolkits will be shipped to this address)

For event planning purposes (such as Divisional and State STEM Competitions):

I understand that if my TAME Club is not at a Title 1 School, I need to recruit students so that at least 60% of student members are from TAME Focus Student groups that are underrepresented in engineering:

Students who are Black/African American, Hispanic/Latinx, or Indigenous/Native American
Female students

Hidden

My club is located in Austin, Dallas, Fort Worth, Houston, San Antonio or in a suburb of one of these cities. I will recruit students so that at least 50% of the club members meet one of the following criteria – Would be first in their family to graduate college :

Yes

At a Title I school

Great! You will be able to register your Co-Leader after you complete this registration.

Hidden

Additional Contacts

Name

Salutation

Please list adults besides Co-Leaders you would like to be included in your TAME Club's emails about registration, toolkits, or Competition (these emails may contain private student data). Example: your school's principal or support staff in your organization.

Hidden

Medications

Hidden

Medical Needs

Medications

Medical Conditions

None

Hidden

Medications

Hidden

Medical Conditions

Hidden

Do you have an active certification in First Aid/CPR?

First Aid

CPR

Neither

Hidden

Student Leaders

Name

Please list any students helping you lead the club (such as a Club President, Team Captain, Recruitment Officer, etc.) who you want to include in general emails about deadlines, competitions, scholarships, contests, etc. These emails will not include rosters or private student data. NOTE: This is not where you register students.

Hidden

Username

Hidden

Untitled

First Choice

Second Choice

Third Choice

Phone

This field is for validation purposes and should be left unchanged.