Consent Form
The Matrix, 566 Mcintyre Street, Regina, Saskatchewan, S4R2M5 Phone:(306)584-3300 or Email to TheMatrixGamingCentreRegina@gmail.com
NOTE - For minor consents, Parent should be seen in-person along with minor at The Matrix and has to be confirmed by our staff !

PARENTAL CONSENT - I hereby give Permission for my child/children* (printed below) to play ESRB Mature 'M' Rated games.Parent/Guardian must verify permission in person prior to this form being placed on file. Note: The Parent/Guardian may change their mind and withdraw permission at anytime by notifying The Matrix.

MEDIA CONSENT - The Matrix Gaming Centre requests your permission to use digital media on our website and other online channels such as but not limited to Facebook & Twitter to share images of your visit to The Matrix Gaming Centre. I grant The Matrix Gaming Centre the right to photograph, videotape and/or record me and to use my name, face, likeness, voice and appearance in connection with exhibitions, publicity, advertising and promotional materials without reservation, limitation or compensation.I hereby authorize any images or video footage taken of myself, in whole or in part, individually or in conjunction with other images and video footage, to be displayed on The Matrix Gaming Centre Website and other official channels including but not limited to Facebook and Twitter, and to be used for media purposes including promotional presentations and marketing campaigns.I waive rights to privacy and compensation, which I may have in connection with such use of my name and likeness, including rights to be written copy that may be created in connection with video production, editing and promotion therewith.

VIRTUAL REALITY CONSENT - For detailed Terms&Conditions, please visit http://www.matrixgaming.ca/?page_id=1514 . I have had sufficient opportunity to read this release agreement and the matrix rules and have read and understood and agree to be bound by their terms. I accept that my user experience involving the matrix virtual reality equipment is dependent on my own ability to follow the instructions provided by the htc vive training video supplemented by any instructions provided by matrix staff.I confirm that I have read and understood this release agreement prior to signing it, and I am aware that by signing this release agreement I am waiving certain legal rights which I or my heirs, next of kin, executors, administrators, and representatives may have against the releases. By signing this release agreement I confirm that I am aware of and understand the risks, dangers and hazards associated with using the service and, by using the service, I voluntarily and knowingly assume and accept all such risks, dangers and hazards and the possibility of personal injury, death, property damage or loss resulting therefrom.

Email address *
Type of Consent Required *
Required
First Name of Player *
Your answer
Last Name of Player *
Your answer
Who's the consent for? *
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