Parental Consent Form
Game Gen, Inc. requires that all parents or legal guardians consent to the following for anyone under the age
of 18 that wishes to join Game Gen as a student. The parent or legal guardian must complete this Parental
Consent Form prior to enrollment or as soon as possible for those already enrolled after this forms
implementation.
Student(s) Name: .
Parent/Guardian Name: .
Relationship: .
Contact Phone: . Contact Email: .
Emergency Contact (If different from Parent/Guardian listed above)
Name: .
Relationship: .
Phone: . Email: .
Agreement
By signing below, I confirm that I am the parent or legal guardian of the person(s) listed above and give my
consent to their participation in the Game Gen program as well as giving permission for Game Gen to:
● Store personal information such as name, age, address, birth date, emergency contacts, conversations
between students and teachers, etc. (Will not be shared with anyone outside of Game Gen)
● Store personal data such as game files, lesson progress, log-in times, written stories, etc.
Signature:______________________________________ Date: .
Date of Birth:_____________