Checkout USD 259's Breakout EDU Boxes
When determining the game to choose, make sure you check all the digital resources, technology needs, and/or extra pieces. I am only able to include what is included in the standard kit: printed resources, large box, three digit box/lock, 4-digit box, word lock, directional lock, hasp, & UV flashlight.

You would need to provide any technology and/or additional locks, boxes, or resources beyond what can be printed from the digital resources found in each game.

Tana Ruder (truder3@usd259.net) will need to come co-teach up to the first few times the boxes are integrated.
**** If a lock or box is unusable after being borrowed, the borrower is responsible for replacing it.

IST will come with the materials needed for the game UNLESS the game requires more than a standard kit supplies. The standard kit: big box, 3-digit smaller box, hasp, 4-digit lock; word lock; directional lock, key lock, thumb drive, UV light, UV pen.

Your Name *
Your answer
School *
Your answer
Room Number *
Your answer
School Email Address *
Your answer
Date Needed *
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Start Time *
Time
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End Time *
Time
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Alternative Date
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Alternative Start Time
Time
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Number of Students *
Your answer
Does this need to repeat for additional sections?
Perhaps you have two reading groups, or 2 & 4 hours need to play. (Example: I need this same game to repeat for my next hour that starts @ 1:00 pm.)
Your answer
Desired Game to Play *
breakoutedu.com has all the games already created. What game are you wanting? If you are needing more than one game in the same day, please fill this form out for that game separately.
Your answer
How Many Boxes Are Needed? *
The district has up to five boxes to borrow. Each box works best with up to eight students but 10-12 adults.
Is the game geared towards Adults or Students *
Required
If there are no hidden clues required, skip the next two set-up questions.
Date to Set-Up
IF things need to be hidden, before or after school could be used to hide clues, hang signs, and take care of that. Lunch time, plan time . .what ever works for YOUR day.
MM
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DD
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YYYY
Time to Set-Up
IF things need to be hidden, before or after school could be used to hide clues, hang signs, and take care of that. Lunch time, plan time . .what ever works for YOUR day.
Time
:
IST will come with the materials needed for the game UNLESS the game requires more than a standard kit supplies. The standard kit: big box, 3-digit smaller box, hasp, 4-digit lock; word lock; directional lock, key lock, thumb drive, UV light, UV pen. *
Required
I understand that I am responsible to replace any broken locks, equipment, or other items associated with Breakout EDU if broken during the time I have the boxes borrowed. *
Required
I understand that Tana Ruder/Kristin Ford will need to co-teach with me up to the first three times a Breakout is utilized in my class to see how a Breakout is ran plus try to minimize ruined locks. *
Required
Additional Comments
Your answer
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