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VSM Minecraft Server

Release and Consent form

I acknowledge that in an effort to provide a safe, monitored online gaming experience, Vineyard Student Ministries have a secured server for the purpose of playing the game Minecraft online. This allows students to play in a community setting while minimizing or eliminating the uncertainties that come with playing online. 

I understand that to ensure this experience, the following steps have been taken by Vineyard Gilbert and Vineyard Student Ministries:

- Each student has to be granted access to the server by going through our application process. They will need to complete a form providing only the necessary information to participate (including contact information, which is used to communicate with students and parents information such as schedules, updates, etc.). Once the form is completed, the parent is required to complete this release/waiver form. Once completed, both the student and the parent will be given the information to set them up on the server. 

- Only those who have completed the process will be given access. They will be added to an approved list that will grant them access. Any users that aren't on the list will be denied access by the server. 

- Students who are in 6th-12th grade will be eligible to be a part of the server. 

- There will be scheduled times that the server will be available for students to play on. These times will be moderated by an approved Youth Leader who has gone through Vineyard Gilbert's background check process. 

- There are rules and guidelines that have been given to the student and the parent on the initial registration form that the students agree to. The rules will also be sent to students in the form of an e-mail as well as be available to view in the server itself. 

- Communication regarding anything involving the Minecraft server will be sent to both the student and the parent. 

 

Consent and Release

I acknowledge that I expressly agree that this release, waiver, and indemnity agreement is intended to be broad and inclusive as permitted by the laws of the State of Arizona and that, if any portion of the agreement is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

I give permission for my student to be a part of the Minecraft Server hosted by Vineyard Gilbert.

I understand that once approved, access is granted using my student’s username. I understand that all action conducted by that username is attached and associated with the username. I know it is my and my child’s responsibility to make sure that no one else gets the password or login information. I do not hold Vineyard Gilbert, Vineyard Youth Southwest and their staff, leaders or adult volunteers as well as other staff, leaders, and volunteers responsible for any conduct from that username or any individuals associated with that username.

Understanding the precautions taken by Vineyard Gilbert to secure the I hereby release and discharge Vineyard Gilbert, Vineyard Youth Southwest and their staff, leaders, or adult volunteers as well as any other staff, leaders, and volunteers for any issues that arise while my student is part of and participating in the Minecraft Server hosted by Vineyard Gilbert. 

 

First Participant Name

First Name*

Middle Name

Last Name*

Phone*
First Participant Date of Birth*
First Participant Signature*
Second Participant Name

First Name*

Middle Name

Last Name*

Phone*
Second Participant Date of Birth*
Third Participant Name

First Name*

Middle Name

Last Name*

Phone*
Third Participant Date of Birth*
Fourth Participant Name

First Name*

Middle Name

Last Name*

Phone*
Fourth Participant Date of Birth*
Fifth Participant Name

First Name*

Middle Name

Last Name*

Phone*
Fifth Participant Date of Birth*
Sixth Participant Name

First Name*

Middle Name

Last Name*

Phone*
Sixth Participant Date of Birth*
Seventh Participant Name

First Name*

Middle Name

Last Name*

Phone*
Seventh Participant Date of Birth*
Eighth Participant Name

First Name*

Middle Name

Last Name*

Phone*
Eighth Participant Date of Birth*
Ninth Participant Name

First Name*

Middle Name

Last Name*

Phone*
Ninth Participant Date of Birth*
Tenth Participant Name

First Name*

Middle Name

Last Name*

Phone*
Tenth Participant Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
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Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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