Registration for Dungeons & Dragons

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Name of Youth/Player *

Age of Youth/Player *

Player's experience level *

New to DnD

Some experience

Lots of experience

Indicate which session you are interested to join. *

Mondays (weekly), 4-6pm

Sundays (biweekly) 1-3pm, next session: Sept 28

Sundays (biweekly) 3:30-pm-5:30pm, next session: Sept 28

Required

Name of Parent *

Parent Phone Number *

Parent Email *

Name and phone number for emergency contact other than parent *

Special medical information we should know

Liability Release

In consideration of my participation and the participation of my child/children in the activities of The Learning Company, I hereby release, indemnify and hold harmless The Learning Company from any and all liability for injuries or loss which I or my minor child/children may incur as a result of said activities for so long as I or my child/children participate in said activities.

I hereby acknowledge that some activities may involve working with potentially dangerous materials or traveling to other locations and conducting activities at those locations. However, I fully accept these risks for me and my child/children and agree to hold harmless and free from any and all liability The Learning Company, its trustees, officers, directors, volunteers, and employees for injuries which may be incurred while engaged in said activities.

I have read and I understand the entirety of this statement and accept all of its provisions.

Signature *

Date *

Submit

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This form was created inside of Princeton Learning Cooperative.