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D&D Club Participant Information Form

Attendee Information


Parent / Guardian Information (Primary Pickup)

Parent / Guardian Information (Secondary Pickup)

Additional Emergency Contact

Medical Release Information

Please list any medical concerns, including any requiring medication (i.e. Diabetic, Asthma, Seizures). If not applicable, please write "N/A"

The purpose of the below listed information is to ensure that medical personnel have details of any medical problem which may interfere

with or alter treatment.

Is your attendee presently being treated for an injury or sickness, or taking any form of medication for any reason?
Is your attendee allergic to any type of food or medication?
Does your attendee require a special diet?

Terms & Policies

D&D Club Payment

D&D Club registration fee is due before the start of the first session to secure their spot. If a registration is not paid they will not be able to attend the club and a spot will not be saved. Payments are accepted at any time to secure their spot.

The financially responsible party signing this form understands and agrees to follow the Registration Payment and Fees Policy. If multiple parties are paying for registration, a registration Agreement is required for all Financially Responsible Parties.

Photo Release

I hereby give permission that my attendee may appear in photographs during the Dungeons & Dragons Club. I understand the photos will be used to keep a journal of activities, and for promotional purposes including flyers, brochures, newspaper and on social media.

Attendees photos and quotes may be used for publicity purposes I understand that although my attendees photograph may be used for advertising, his or her identity will not be disclosed, I do not expect compensation and that all photos are the property of Goblets & Goblins Inc.


Dungeons & Dragons Club and its co-organizers are not responsible for lost or damaged personal property. All scheduled events are subject to change. I understand that no fees will be refunded or transferred unless the attendee is unable to participate due to an accident or illness per physician orders or a lockdown/restriction is put in place by the government.

I understand that there is a ZERO tolerance bullying and harassment policy for Dungeons & Dragons Club and that anyone attending this

club will immediately be expelled from attending and their parents/guardians will be called. I will receive no refund or compensation if the attendee signed to this club uses profanity, name calling, racial slurs, general bullying, physicality or/and any other form of harassment towards staff/other club members.

General Indemnity

I, the undersigned*, herby release discharge, indemnify, hold harmless and defend Goblets & Goblins Inc, its officers, employees and servants from any and all liability (claims, demands, losses, causes of action, suits, judgements) of any kind that I or my family may have against Goblets & Goblins Inc due to death, personal injury

or illness, loss or damage to property, or future causes that occur during the Dungeons & Dragons Club. In the event of any medical emergency and I or emergency contacts cannot be reached, I authorize and consent for Goblets & Goblins Inc to call for additional medical assistance.

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