Student Last Name *

Student First Name *

Student Grade *

Cell Number w/Area Code *

Name on Back - MUST NOT EXCEED 6 LETTERS. Must be school appropriate. Numbers are randomly assigned. *

1st period teacher *

Do you want to play in the game? Respond with YES or NO. *

HAS YOUR PARENT/GUARDIAN REVIEWED THE CONSENT FORM? RESPOND YES OR NO. COPY & PASTE LINK TO VIEW THE FORM: https://docs.google.com/document/d/13aRJwgth0z7VlC56ik6oC3Wxk7I_Jf1my1uwokDGhxk/edit?usp=sharing *

PARENT/GUARDIAN FIRST & LAST NAME *

PARENT/GUARDIAN CELL NUMBER *

AS THE PARENT/GUARDIAN OF THE PARTICIPATING STUDENT, I HAVE READ AND UNDERSTAND THE PARENTAL PERMISSION FORM. RESPOND YES OR NO *

PARENT/GUARDIAN EMAIL *

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