2024 Camp Registration Form | Across the Board Game Cafe

Camp Attendee Info

What we need to know about the child attending the camp program. Each child will be required to register separately. Fields marked with an asterisk are required.

Child's Name*

First Last

Program Child Will Be Attending*

Child's Age*

Please enter a number from 7 to 17.

Child's Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Does your child have any allergies or dietary restrictions?*

Does your child require any medications or have any other medical conditions we should know about?*

Does the camper have any prior Dungeons & Dragons experience? (none required) Have they attended any of our previous D&D events or camps?

Are there other registered campers you would like your camper to be grouped with?

What name was the camper's ticket purchased under? (Only required if different than parent/guardian below)

Is there anything else we should know?

Parent/Guardian Information

Info about legal guardians. Anyone picking up a camper must be registered with us ahead of time, and will be required to show photo ID upon pickup.

1st Parent/Guardian's Name*

First Last

1st Parent/Guardian's Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

1st Parent/Guardian's Phone Number*

2nd Parent/Guardian's Name

First Last

2nd Parent/Guardian's Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

2nd Parent/Guardian's Phone Number

Additional emergency contacts, pickup authorizations, guardian info, etc

Phone numbers and addresses must be provided for all additional contacts/authorized persons.

Liability and Conditions*

I agree to the following releases, waivers, and return policy.

1. Liability Waiver and Release: In consideration of the child named on this form (the camper) being allowed to participate in Across The Board's Day Camp Programs, the camper’s guardian or parent, hereby releases Across The Board Game Cafe Inc., and its trustees, directors, officers, servants, volunteers, representatives and agents from and against all claims, actions, demands, costs and expenses relating to injury, death, damage to person or property or loss of property, howsoever caused, arising out of or in connection with the camper’s participation in Across The Board's Day Camp Program.

2. Payment conditions and refund policy: Cancellations made 3 or more days in advance of the session start date will be fully refunded. Cancellations made less than 3 days in advance of the session start date will be issued a credit in the form of a gift card. The credit can be used for any other services or goods from Across The Board.

3. Photo/Video Release: I irrevocably and unconditionally consent and agree, on my own behalf and on behalf of my child or children (including any children for whom I act as guardian) that any moving pictures, videos, still photographs, video recordings and/or audio recordings taken of my child or children, while in attendance at Across The Board Day camp programs, or otherwise participating in activities organized by Across The Board, may be utilized by Across The Board and its successors and assigns for any reasonable purpose connected in any manner with the activities and operations of Across The Board (and its successors and assigns), anywhere in the world, in any present or future format; and, I further irrevocably and unconditionally consent and agree that Across The Board (and its successors and assigns) will own in perpetuity all rights, title, and interest to any of the said moving pictures, videos, still photographs, video recordings and/or audio recordings of my child or children represent, without remuneration or benefits of any kind payable to myself or to my heirs, successors or assignees.

4. Notice of illness: To the best of my knowledge, my child is in good health. I will notify the camp, in writing, if my child is exposed to any infectious disease, or if any change in health status occurs during the three weeks (21 days) prior to the camp session.

The Release in paragraph 1 shall be binding upon the camper, the undersigned and the estates of the camper and of the undersigned. I have read and understood the above Release.

Camp Attendee Info

Parent/Guardian Information

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