Parent Permission Slip for Massillon Public Library lan party

Дата канвертавання27.04.2016
Памер10.04 Kb.
Parent Permission Slip for Massillon Public Library LAN Party

I ______________________________do hereby give permission for my child ____________________________

(Print Parent/guardian’s name) (Print Child’s name)

to participate in the Massillon Public Library’s LAN Parties Saturday evenings from 5:30 p.m.-9:00 p.m. I understand that some of the games being played, such asTeam Fortress 2, Half Life 2, Counter-Strike, Team Fortress Classic, Day of Defeat, Deathmatch Classic, Left4Dead, Left4Dead 2 and Garry’s Mod by Valve Software, have an ESRB rating of M (Mature). A second game, Portal, by Valve Software, has a rating of T (Teen). A Library Card is required for each event, when you enter.

These games are team-based, first-person games. While winning is objective-based and not based on “kill count,” these games do include the simulated use of weapons and a high level of cartoon violence. Portal is a puzzle game with minimal violence.
I also understand that this event is open to all adults and teens ages 14 and up. Library chaperones will be on site all evening.
In addition, if my child brings his/her own equipment, I understand that I am responsible for all equipment and that the Massillon Public Library cannot be held responsible for any loss including but not limited to damage or theft.
I understand that I have been given the opportunity to preview the game being played anytime up to, and including the date of the event by calling 330-832-9831 ext. 332 to set up an appointment.

In case of an emergency, please contact:

1) ________________________, _______________________ at _____-_____-________

(Name) (Relationship) (Phone number)

2)________________________, _______________________ at _____-_____-________

(Name) (Relationship) (Phone number)


_________________________________________________ ___________________

(Parent/Guardian’s Signature) (Date)

If you would like this permission form to serve as a blanket permission for all future library LAN gaming events, including games that are not listed on this form, please sign the box below.

I _______________________do hereby give permission for my child ______________________

(Parent/guardian’s name) (Child’s name)

to participate in all future Massillon Public Library’s LAN parties.

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