Educational Mathematics Games

Educational Mathematics Games — Participant Consent & Program Agreement

Participant Information

Student Name:

Date of Birth:    Student ID:    Grade/Program:

Program Details

Program Title:

Session Start Date:    Regular Session Times:

Tuition / Fee (if applicable):    Payment Plan:

Parent / Guardian Information

Emergency & Medical Information

Emergency Contact Name:    Phone:

Program Policies, Consent, and Acknowledgments

Participation Authorization — I authorize the student named above to participate in the Educational Mathematics Games program. I acknowledge that program activities include collaborative problem solving, timed and untimed game play, digital and physical manipulatives, and occasional small-group competition. I accept responsibility for ensuring the student follows coach and staff directions.

Code of Conduct — I acknowledge that the student must follow the program code of conduct and that the program may remove a participant for failure to comply. The program reserves the right to modify activities for safety or instructional reasons.

Medical Release — In the event of a medical emergency, I authorize program staff to administer first aid and to seek emergency medical treatment for the student. I agree to be financially responsible for any emergency care obtained.

Intellectual Property and Use of Student Work — Projects, problem solutions, and other materials produced during program activities may be retained for educational assessment and may be used for program promotion or instruction. By signing, I grant the program a nonexclusive, royalty-free license to reproduce and use such materials for educational purposes, provided the student's full name is not used without separate consent.

Data Collection and Assessment — I acknowledge that staff may collect performance data and assessment results for instructional improvement and program evaluation. Collected data will be handled in accordance with applicable institutional privacy practices; personally identifying information will be limited to what is necessary for program administration.

Liability and Indemnification — To the fullest extent permitted by law, I release and hold harmless the program, its employees, volunteers, and agents from claims arising out of the student's participation except for claims resulting from wilful misconduct or gross negligence. I agree to indemnify the program for claims arising from my willful acts or omissions or those of the student.

Permissions & Checkboxes

  I authorize the student to participate in all scheduled Mathematics Games activities.

  I grant permission for the student to be photographed or recorded during program activities for educational and promotional use, subject to the Intellectual Property clause above.

  I consent to collection of assessment and performance data for instructional and program evaluation purposes.

  I have read and understand the Liability and Indemnification clause and accept the terms stated in this agreement.

Certification

By signing below, I certify that the information provided on this form is true and complete to the best of my knowledge. I understand that false statements or omissions may result in removal from the program. I acknowledge that I have read and agree to the terms, policies, and releases stated in this form.

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