2025-26 - Game Club Student Registration for Madison Elementary

Please complete this form so your child can participate in Game Club - Game Club, a free Games Reach program made possible by the generous donations of time and resources' from those within your community just like you!

General Information

Student's Name
Please Verify that you are registering a student for the Madison High School Game Club. (If not, please note that there are different forms for each school) *
Verification MHS

"Club T-shirts are free—courtesy of our local sponsors!"

Both Youth and Adult sizes available
Both Youth and Adult sizes available
Student Address
Parent/Guardian # 1
Parent/Guardian # 2
How will the student be getting home from club?

Emergency Contact Information

If you want to add another contact; please use the... "Is there anything else we should know?" field at the end of this form. Thanks!
Name of Emergency Contact - Must be someone other than Parent/Guardian #1 or #2

Medical Information

Confirmation

* To the best of my knowledge, the information contained in this form is accurate.

Participation Consent and Comment

The above-named child has my permission to attend Game Club each week. (There will be no club on days without school.)

Conditions of Participation

  • Provide and update contact information for myself and my emergency contacts.
  • All Game Club families are required to use the REMIND Communication Platform. REMIND is our primary method of communication and is also used by the school. This ensures that all families receive timely updates regarding club cancellations, student pick-up issues, event invitations, and other important information.
    Further details about joining REMIND will be provided on the confirmation page after you submit this form.
  • Ensure that my child is picked up on time after Game Club.
  • Contact a club Team Leader as soon as possible if there is a delay.

I understand that failure to pick up my child on time may jeopardize their continued participation. Furthermore, club leadership must arrange transportation with the authorities if I (or my emergency contacts) cannot be reached within 30 minutes of the club's end.

Waiver

I, the undersigned, give permission for my son/daughter (named in this form) to participate in Game Club. I understand that while precautions are taken to ensure safety, there are always risks associated with any physical activity, including, by way of example, physical injury due to activity-related accidents, illness (including, but not limited to, COVID-19, MRSA, influenza, and other infectious or communicable diseases), or even death. In addition, I acknowledge that there may be other risks inherent in these activities of which I may not be presently aware.


By signing this form, I expressly assume all risks related to participating in the activities, whether such risks are known or unknown to me at this time. I release and agree to indemnify and hold harmless Games Reach and its employees, volunteers, and agents from any and all claims arising from participation in any of its activities and programs.

Photos/Videos may be taken at the club. Please check the box below if you DO NOT give permission to have your child's photograph taken.
Photo/Video Consent
Clear Signature
Parent/Guardian Name