Artemis ROADS II: Injection Burn Stage Deadline 🗓

Upload information about your student crew members, their Mission Patch (MO-2), and signed Risk and Release forms to receive a social media shout-out from NESSP and a package with stickers, a certificate of participation, and a NASA calendar (while supplies last).

This form is required for all Artemis ROADS II challenge teams and must be submitted before the February 7th, 2024 deadline, at 5 PM PST.

To complete this form, Mission Advisors will need:

• Team information, including the team number and name
• Student information, including age, ethnicity, and gender
• A Risk and Release Form for each student signed by a parent or guardian
• An image (jpg, jpeg, png, or pdf) of the student team’s mission patch

The student team should provide brief answers to the following questions:

• What is the rationale for choosing the team name?
• How does the design of the mission patch represent the mission?
• How does the design of the mission patch represent the team or the team’s community?

You can preview this whole form before filling it out here.

– Step 1 of 4

Team Number *

Team Name *

Mission Advisor's Name *

First

Last

Organization's Name *

Primary Mission Advisor's Email *

Primary Mission Advisor's Backup Email *

In the event your primary doesn’t work, or is restricted we will contact you via this backup email.

Phone *

Team Category *

• Pegasus grades 3 – 5 max age 11 years old
• Crawler grades 6 – 8 max age 14 years old
• Astrovan grades 9 – 12 max age 18 years old

Choose a category based on the oldest member of the team. Only Crawler and Astrovan team members who are at least 12 years of age at registration are eligible for NASA space center trip.

Number of Team Members

Selected Value: 3

Number of English Speakers *

Number of Spanish Speakers *

Next

Name of Team Member 1 *

First

Last

Age of Team Member 1 *

Ethinicity of Team Member 1 (select all the apply) *

• Asian
• Black or African American
• Hispanic or Latino
• Native American or Alaska Native
• Native Hawaiian or Other Pacific Islander
• White
• Prefer not to answer
• Other

Gender of Team Member 1 *

• Male
• Female
• Prefer not to answer
• Other

Risk and Release Form for Team Member 1 *Must be signed by student & parent* *

Click or drag a file to this area to upload.

Accepted formats: .pdf, .jpg, .jpeg, .png.

Name of Team Member 2 *

First

Last

Age of Team Member 2 *

Ethinicity of Team Member 2 *

• Asian
• Black or African American
• Hispanic or Latino
• Native American or Alaska Native
• Native Hawaiian or Other Pacific Islander
• White
• Prefer not to answer
• Other

Gender of Team Member 2 *

• Male
• Female
• Prefer not to answer
• Other

Risk and Release Form for Team Member 2 *Must be signed by student & parent* *

Click or drag a file to this area to upload.

Accepted formats: .pdf, .jpg, .jpeg, .png.

Name of Team Member 3 *

First

Last

Age of Team Member 3 *

Ethinicity of Team Member 3 *

• Asian
• Black or African American
• Hispanic or Latino
• Native American or Alaska Native
• Native Hawaiian or Other Pacific Islander
• White
• Prefer not to answer
• Other

Gender of Team Member 3 *

• Male
• Female
• Prefer not to answer
• Other

Risk and Release Form for Team Member 3 *Must be signed by student & parent* *

Click or drag a file to this area to upload.

Accepted formats: .pdf, .jpg, .jpeg, .png.

Name of Team Member 4 *

First

Last

Age of Team Member 4 *

Ethinicity of Team Member 4 *

• Asian
• Black or African American
• Hispanic or Latino
• Native American or Alaska Native
• Native Hawaiian or Other Pacific Islander
• White
• Prefer not to answer
• Other

Gender of Team Member 4 *

• Male
• Female
• Prefer not to answer
• Other

Risk and Release Form for Team Member 4 *Must be signed by student & parent* *

Click or drag a file to this area to upload.

Accepted formats: .pdf, .jpg, .jpeg, .png.

Name of Team Member 5 *

First

Last

Age of Team Member 5 *

Ethinicity of Team Member 5 *

• Asian
• Black or African American
• Hispanic or Latino
• Native American or Alaska Native
• Native Hawaiian or Other Pacific Islander
• White
• Prefer not to answer
• Other

Gender of Team Member 5 *

• Male
• Female
• Prefer not to answer
• Other

Risk and Release Form for Team Member 5 *Must be signed by student & parent* *

Click or drag a file to this area to upload.

Accepted formats: .pdf, .jpg, .jpeg, .png.

Name of Team Member 6 *

First

Last

Age of Team Member 6 *

Ethinicity of Team Member 6 *

• Asian
• Black or African American
• Hispanic or Latino
• Native American or Alaska Native
• Native Hawaiian or Other Pacific Islander
• White
• Prefer not to answer
• Other

Gender of Team Member 6 *

• Male
• Female
• Prefer not to answer
• Other

Risk and Release Form for Team Member 6 *Must be signed by student & parent* *

Click or drag a file to this area to upload.

Accepted formats: .pdf, .jpg, .jpeg, .png.

PreviousNext

MO-2 submission – Image of your Mission Patch *

Click or drag a file to this area to upload.

Please upload a copy of your mission patch. Remember that Mission patches are 500 x 500 Pxls and are must be .png, .pdf, .jpg, or .jpeg files.

Why did the students choose the team name? *

50 words maximum

How does the team's mission patch represent the mission? *

50 words maximum

How does the mission patch design represent the team and/or the team's community? *

50 words maximum

When would you like your shoutout on social media? *

• Morning 9 am -12 pm Pacific
• Afternoon 12 pm – 3 pm Pacific
• Evening 3 pm – 6 pm Pacific

PreviousNext

Updating preview…

This is a preview of your submission. It has not been submitted yet!
Please take a moment to verify your information before clicking the submit button below. You can also go back to make changes.

Previous

Submit