Newburg Gaming Club Permission form Starting with the 2017-2018 School Year, the Newburg R-II School District will be hosting a gaming club available to students in grades 9-12. This event is created and is run by Max Neff, the school’s Technology Coordinator. The event will be after school on Tuesdays and Wednesdays from 3:30pm to 6:00pm, students will sign up for one day each week. Students may arrive or leave at any time during that window, but students without a driver’s license must be picked up by a parent or guardian. The event will be held in the spare room near Mr. Jessen’s Choir room. Any students who wish to attend the weekly club must have a parent or legal guardian sign and return this permission form. Also, should any parent be concerned, he/she may stay and observe for as long as desired. Below you will find a list and description of the types of games that will be played. NOTE: Some games may contain violence and/or inappropriate language. However, I will not allow any content with nudity. Also, no online gaming will be allowed; everything will be local multi- player games only. Some drinks like water, soda, and Gatorade may be provided from time to time, but no food will be allowed in the room. Drinks must be kept either in hand or set in the designated area. For the protection of the students, staff, and property, a camera will be running at all times inside the room and outside the door. Should any student be responsible for damaged or stolen property, the parent assumes full responsibility for the cost of replacing the items. Parents may call the Game Room directly at 573-762-9653 ext. 1318. Current list of games: Halo: Master Chief Collection Arcade Classics Rocket League NES, SNES, N64, and Sega Classics Minecraft Dance Dance Revolution Mortal Kombat XL Rockband 2, 3, Beatles Marvel vs Capcom 3 Forza 4 Street Fighter IV Burnout Revenge CoD: Black Ops III Naruto UNS4: Road to Boruto Mario Kart 8 Unreal Tournament 2004 Super Smash Bros: Wii-U Nintendo Land I hereby agree to the above mentioned rules and allow my child to attend. Student’s Printed Name:________________________ Parent’s Signature:_________________________ Date:_________________ .