Game Development Club Enrollment Form

Join our creative community of young game developers!
Student Information
Full Name:
 
Age:
 
Perferred Mode of Instruction:
Online
In-Person
Hybrid
Experience Level:
Beginner
Intermediate
Advanced
Areas of Interest:
Coding
Art
Storytelling
Game Design
Other: ________________
Parent/Guardian Information
Full Name:
 
Phone Number:
 
Email Address:
 
Preferred Contact Method:
Email
Phone
Text
Emergency Contact & Medical Information
Emergency Contact Name:
 
Phone Number:
 
Allergies or Medical Conditions:
 
Special Accommodations (if any):
 
Technology & Learning Preferences
Does the student have access to a computer for game creation?
Yes
No
Preferred learning style:
Hands-on
Visual
Structured Lessons
Self-paced
Any previous exposure to game creation tools or programming languages?
 
Permissions & Consent
Participation Consent: I give my child permission to participate in the game development program.
Media Release: I allow my child's photos/videos to be used for promotional or educational purposes.
Internet Usage Agreement: I understand my child may use online tools/software for learning.
Parent/Guardian Signature:
Date:
 
Game Development Club Enrollment Form