Paragraph. PARENTAL CONSENT FORM
Permission to Participate
For your child to play at Game Play, we require your consent. If you have any questions about this form, please feel free to contact us during our business hours at 000-000-0000. Our hours can be found here www.gameplay.com Please read, complete and sign the following:
I am the parent or legal guardian of _______________________________ (“Minor”) who is under 17 years of age. I hereby consent to Minor's use of the console video games. I am aware the console video games may have a rating of “M” for Mature as specified by the Entertainment Software Ratings Board. I am aware this rating indicates the ESRB has deemed the content of the console video game to be unsuitable for children under 17 years old. ESRB ratings appear on the back of every video game box, and further information can be found at www.esrb.org.
By my signature below as the Parent or Legal Guardian, I give my permission to allow the Minor to play at Game Play without restriction or limitation, including, without limitation playing console video games with ESRB ratings of “M”, and I release Game Play including its owners, organizers, sponsors, and affiliates from any and all liabilities that may arise from my decision to allow the Minor to play there.
Additionally, I as the Parent or Legal Guardian, assume all responsibility and liability for any injury, minor or serious, accidental or intentional, to Minor while at any special events or during regular and extended hours.
Parent or Legal Guardian
_______________________________ __________________
Signature of Parent or Legal Guardian Date
_______________________________
Printed Name of Parent or Legal Guardian
Address of Parent / Legal Guardian: ___________________________________
Telephone # of Legal Guardian: ___________________________________
Emergency Contact & Phone Number: _________________________________
Permission to Participate
For your child to play at Game Play, we require your consent. If you have any questions about this form, please feel free to contact us during our business hours at 000-000-0000. Our hours can be found here www.gameplay.com Please read, complete and sign the following:
I am the parent or legal guardian of _______________________________ (“Minor”) who is under 17 years of age. I hereby consent to Minor's use of the console video games. I am aware the console video games may have a rating of “M” for Mature as specified by the Entertainment Software Ratings Board. I am aware this rating indicates the ESRB has deemed the content of the console video game to be unsuitable for children under 17 years old. ESRB ratings appear on the back of every video game box, and further information can be found at www.esrb.org.
By my signature below as the Parent or Legal Guardian, I give my permission to allow the Minor to play at Game Play without restriction or limitation, including, without limitation playing console video games with ESRB ratings of “M”, and I release Game Play including its owners, organizers, sponsors, and affiliates from any and all liabilities that may arise from my decision to allow the Minor to play there.
Additionally, I as the Parent or Legal Guardian, assume all responsibility and liability for any injury, minor or serious, accidental or intentional, to Minor while at any special events or during regular and extended hours.
Parent or Legal Guardian
_______________________________ __________________
Signature of Parent or Legal Guardian Date
_______________________________
Printed Name of Parent or Legal Guardian
Address of Parent / Legal Guardian: ___________________________________
Telephone # of Legal Guardian: ___________________________________
Emergency Contact & Phone Number: _________________________________
