Parent Agreement, Waiver and Media Release - AoE Esports

Parent Agreement, Waiver and Media Release

"*" indicates required fields

Parent Name*
2nd Parent Name
Child Info*
Name
Gender
Birthday
Medical Issues (if any)
 
Additional Persons Authorized for Pick-up
Name
Phone
Email
Relationship
 
Emergency Contact Name*
This field is for validation purposes and should be left unchanged.
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