Robot Team Registration Twenty-Fourth AAAI Conference on Artificial Intelligence July 11 – 15, 2010 n Westin Peachtree Plaza Robot Team Name: ________________________________________________________________________________________________________ Robot Name: _____________________________________________________________________________________________________________ Contact Name: _______________________________________________ Company/Univ.: _______________________________________ Address: _____________________________________________________ Dept./MS:___________________________________________________ City: ________________________________________________________ State: ______________________________ Zip: ____________________ Country: ____________________________________________________ Team is: n Exhibitor n Competitor n Both Daytime Phone ______________________________________________ Fax: ________________________________________________________ E-mail Address ___________________________________________________________________________________________________________ Robot Team Agreement The Robot Team agrees to comply with any applicable laws, regulations, or ordinances of AAAI–10, Atlanta, Georgia, and the Westin Peachtree Plaza. This contract shall not be binding unless and until it is accepted in writing by AAAI. Read and accepted by: (signature): ________________________________________________________________________________ (print name): ________________________________________________________________________________ Date: ________________________________________________________ 2010 Amount Enclosed The robot registration cost is $250.00 USD per team. Payment is due on or before June 15, 2010. All payments are nonrefundable. A one time fee of $250.00 will be charged for teams from the same institution and working on the same robot in the case of multiple entries. Method of Payment (Check One): n MC n Visa n Amex n Check (payable to AAAI and drawn on a US Bank) n US Govt. PO Credit Card Number: _____________________________ Expiration Date: ______________________ Name on Card: __________________________________ Card Verification Number:* ____________ Business Name: _________________________________ Signature: ____________________________ Credit Card Billing Address: _______________________________________________________________ *The card verification number on Visa and Mastercard is a 3-digit number printed on the back of your card. It appears after and to the right of your card number. On American Express cards, the verification number is a 4digit number printed on the front of your card. It appears after and to the right of your card number. Send with payment to Robot Team Registration Association for the Advancement of Artificial Intelligence 445 Burgess Drive, Suite 100 Menlo Park, CA 94025-3442 650 / 328-3123; USA Fax: 650 / 321-4457 Deadline: June 15, 2010