Waiver Video Games

I have read the Excelsior Academy Consumer Disclosure for Electronic Delivery in accordance with the U.S. Electronic Signatures in Global and National Commerce Act (the E-Sign Act) and agree to signing my enrollments forms electronically.*
- Confirm
Parent/Guardian Name*
Student Name*
Email
I grant my child "student" permission to participate in video games rated the following:*
- Everyone 10+ (Ages 10+)
I grant permission to allow my student to play the following video games OR similar types of video games
- Super Smash Bros- Rated E for Everyone
- Overcooked (Cooking Simulation)- Rated E for Everyone
- Plants vs Zombies (Tower Defense)- Rated E^10+ for Ages 10+
- Super Mario Kart- Rated E for Everyone
- Super Mario Bros- Rated E for Everyone
Electronic Signature*
(use your finger for touchscreen)

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