Nevada Partners Esports League -Application

Participant Information

First Name *

Last Name *

Phone Number *

Email Address *

Address

Street Address *

City

State

Postal Code

Are you currently enrolled in school? *

Currently Enrolled

Not Currently Enrolled

Name of the school where you are currently enrolled: *

Date of birth *

Gamer Tag / Username

Is the participant under 18? *

Yes

No

Parent/Guardian Information

Parent / Guardian Full Name

Parent/Guardian Phone Number

Parent/Guardian Email

Emergency Contact Information

Emergency Contact: Full Name *

Relationship *

Emergency Contact: Phone # *

Program Requirements

Does the participant require transportation? *

Select

Yes
No
Maybe
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Are you disabled, handicapped, or need any accommodations?

Attendance & Participation Agreement

Please check all of the boxes below. *

I understand that the participant must attend all mandatory training sessions on Mondays between December 15 and December 29 in order to remain eligible to compete.

I understand that the participant must attend all mandatory training sessions on Mondays between December 15 and December 29 in order to remain eligible to compete.

I understand that the participant must attend all mandatory training sessions on Mondays between December 15 and December 29 in order to remain eligible to compete.

I understand that the participant must attend all mandatory training sessions on Mondays between December 15 and December 29 in order to remain eligible to compete.

Media Release Consent

I grant permission for Nevada Partners to use photos, video, and gameplay footage of my student for program documentation, marketing, and promotional purposes. *

Yes

No

Technology & Safety Agreement

Please check all of the boxes below. *

I acknowledge that the participant must follow Nevada Partners’ digital safety guidelines and uphold appropriate online behavior during practices, competitions, and all esports-related activities.

I acknowledge that the participant must follow Nevada Partners’ digital safety guidelines and uphold appropriate online behavior during practices, competitions, and all esports-related activities.

Parent/Guardian Acknowledgement

Please check all of the boxes below. *

I confirm that I am the parent or legal guardian of the participant.

I have reviewed and agree to all program requirements, agreements, and consents provided in this application.

I have reviewed and agree to all program requirements, agreements, and consents provided in this application.

Participant Acknowledgement

Please check all of the boxes below. *

I agree to follow all esports rules, practice expectations, and online safety guidelines during trainings, games, and all program activities.

I understand that failure to follow program expectations may result in disciplinary action or removal from the team.

Participant or Parent/Guardian Signature

Today's Date