Odyssey of the Mind Region 12
Odyssey of the Mind Region 12
Tournament Registration Worksheet
We recommend you complete a copy of this worksheet prior to starting the online registration at This is a worksheet - NOT the tournament registration form. Completing this worksheet will simply aid you in the online registration process. You must enter all the information found in this worksheet into the online application to register your team. The online form entry requires you complete the registration in one sitting. If you exit the registration process mid-way, or you are timed out while get some information, the website will exit without saving the information previously entered. Therefore, you will be required to restart the data entry process from the beginning.
Online registration requires your team’s judge and volunteerregistration numbers, first and last names. Before completing this form or the on-line application, you must identify your judge and volunteer and have them register at The online registrations willcross-check this registration information to confirm their registration prior to allowing the team registration to continue.
Team registration is not complete until the online registration is complete and our treasurer hasreceivedpayment of the Tournament Registration Fee no later than January 31, 2014. Payment must be made by check, made out to "NoVA South, Inc" and mailed to the address below. Please put your team ID number (which you will receive by email when you’ve completed the online registration) on the check. If your Tournament Registration Fee is being paid as one of a group of teams (for example, the school PTA is paying for all teams) be sure to advise your school coordinator to include your team’s ID number so that all team ID numbers can be included on the group check.
Mail your tournament registration check to: Mary Beth Pilipczuk, Treasurer
6820 Farrahs Cavalry Rd
Centreville, VA 20121
Please do not request a receipt from the Treasurer. Your cancelled check and registration email are your payment receipt. You may contact the Treasurer .
Thanks for signing up!
Your School:This information is a pull-down item list on the online registration page
Name:
Your Team Selected Problem:
This information is a pull-down item list on the online registration page
Selected Problem: / 1 2 3 4 5 Primary
(check one)
Your Judge:
Your must have a judge register first at to obtain an ID number.
The ID number entered online must match the information received by your judge’s emailregistration letter.
ID Number:
First Name:
Last Name:
Your Volunteer:
Your must have a volunteer register first at to obtain an ID number.
The ID number entered online must match the information received by your volunteer’s email registration letter.
ID Number:
First Name:
Last Name:
Your Coach:
First Name:
Last Name:
Address:
City:
State:
Zip Code:
Daytime Phone:
Evening Phone:
Email: / Once you complete the online registration, your team number and
registration information will be automatically sent to this email address.
Your Alternate Coach:
First Name:
Last Name:
Daytime Phone:
Evening Phone:
Email:
Team Member # 1:
First Name:
Last Name:
Grade:
Team Member # 2:
First Name:
Last Name:
Grade:
Team Member # 3:
First Name:
Last Name:
Grade:
Team Member # 4:
First Name:
Last Name:
Grade:
Team Member # 5:
First Name:
Last Name:
Grade:
Team Member # 6:
First Name:
Last Name:
Grade:
Team Member # 7:
First Name:
Last Name:
Grade:
Note: Your team’s competition division will be automatically calculated once
you have entered your team member information online.
This entry should reflect any scheduling issues thecoach or team members may have during tournament day. Please be specificwhen identifying a conflict. We need to know the problem and division information
to avoid schedule conflicts. Some examples include:
I coach two teams, my other team is Problem 2, Division 3 from Patriot HS; or
This team is competing in two problems. Our other problem is Problem 3, Division 2from Stone MS;or
This team needs to leave by 2:00PM due to a band concert; or
One of the parent’s has a child on another team, Problem 3, Division 3, from Westfields HS.
Special Considerations:
This entry should reflect any special considerations that yourcoach or team member may have during
tournament day. Some examples include: Handicap accessibility, etc…
This is a worksheet - NOT the tournament registration form
NOVA South, Inc.Page 1 of 4
2013-2014