Clone of Games Reach - Tabletop Game Club (Madison High School)

Games Reach - Tabletop Game Club (Madison High School)

Game Club is FREE. Students must be registered by a legal guardian.
NOTICE --- This Club has merged with the Middle School. Please complete this form for you high school student. NOTE -- they will need to walk to the Middle School on THURSDAYs if they wish to join us. --- NOTICE

Thank you for your patience and understanding. This change was necessary because of our current high school registration numbers. We hope more students will sign up soon, allowing us to return to holding a separate game club at the high school. In the meantime, high school students have a great opportunity to serve as positive role models and mentors to younger students. This leadership experience can also strengthen college and job applications.- Jadaé Fox - Executive Director – Games Reach
If the school listed above is not the correct school, please go back and select the correct school and its corresponding registration. Thank you!
Verification
How did you hear about Game Club?
Student Info
Student's Legal Name

First NameLast Name
Student's Preferred Name (nickname)

First NameLast Name
Gender
Grade
Student's shirt size
Parent/Guardian Info
Parent/Guardian # 1 Name

First NameLast Name
What is your relation to the Student?
Parent/Guardian # 1 Phone
Format: (000) 000-0000.
Parent/Guardian # 1 Email
Parent/Guardian # 2 Name

First NameLast Name
What is your relation to the Student?
Parent/Guardian # 2 Phone
Format: (000) 000-0000.
Parent/Guardian # 2 Email
example@example.com
Games Reach communicates primarily through Clearstream text messaging. Please save (419) 502-3880 in your phone.
Who should receive Games Reach Texts? (419) 502-3880
Emergency Contacts
Name of Emergency Contact - Must be someone other than Parent/Guardian # 1 or # 2

First NameLast Name
What is their relation to the Student?
Emergency Contact Phone
Format: (000) 000-0000.
Pick-up / Walking?
How will the student be getting home from club?
Additional Authorized Pickup List

In addition to Parent/Guardian 1, Parent/Guardian 2, and your emergency contact, please list any other adults who are authorized to pick up your child from Game Club.
Authorized Pickup Name (not parents/guardians or emergency contact)

First NameLast Name
Authorized Pickup Relationship
Authorized Pickup Name (not parents/guardians or emergency contact)

First NameLast Name
Authorized Pickup Relationship
Heath and Safety
Is there a custody arrangement or dispute regarding your child? (If yes, Please explain.)
Please list any known food allergies, dietary restrictions, and environmental Allergies?
Please list any health/behavioral conditions or physical/mental limitations we should know.
Is there anything else you feel we should know?
I understand and agree to the following
I understand
I understand
I will
I will
I understand that
Liability Waiver and Photo Release
Photo/Video Opt-Out
Parent/Guardian Full Name

First NameLast Name
Signature
Would you like to stay connected or get involved with Games Reach? -- Check all that apply
Check all boxes that apply!

Other
Optional Donation to help defray costs of Game Club

Games Reach is completely donor and volunteer supported!
Would you like to Support Games reach? (Optional Donation)

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Games Reach - Tabletop Game Club (Madison High School)

NOTICE --- This Club has merged with the Middle School. Please complete this form for you high school student. NOTE -- they will need to walk to the Middle School on THURSDAYs if they wish to join us. --- NOTICE

If the school listed above is not the correct school, please go back and select the correct school and its corresponding registration. Thank you!

Student Info

Parent/Guardian Info

Games Reach communicates primarily through Clearstream text messaging. Please save (419) 502-3880 in your phone.

Emergency Contacts

Pick-up / Walking?

Additional Authorized Pickup List

Heath and Safety

I understand and agree to the following

Liability Waiver and Photo Release

Would you like to stay connected or get involved with Games Reach? -- Check all that apply

Optional Donation to help defray costs of Game Club

Would you like to Support Games reach? (Optional Donation)

Payment Methods