Roblox Club Waiver of Participation and Photo Release Agreement
By Completing this Form, you agree with the Participation and Photo Release Agreement as described below.

Waiver of Participation

As a participant (or as the parent/guardian of a participant under the age of 18) in the ROBLOX Club and/or any other activities managed by First Coast Esports Alliance Inc, I acknowledge and agree to the following:

  1. Voluntary Participation: I acknowledge that participation in club activities, including esports, gaming, technology workshops, and related events, is voluntary.

  2. Assumption of Risk: I understand that participation in club activities involves certain risks, including but not limited to physical or technical injury and equipment damage. I voluntarily assume all such risks.

  3. Release of Liability: I release and hold harmless First Coast Esports Alliance Inc, its staff, volunteers, and partners from any and all liability, claims, or demands for personal injury, illness, death, or property damage that may arise from participation in club activities, whether on-site or off-site.

  4. Medical Emergency: In the event of a medical emergency, I authorize First Coast Esports Alliance Inc staff to seek medical treatment for the participant if necessary. I agree to be financially responsible for any medical treatment that may be provided.

  5. Adherence to Rules: I agree to abide by all club rules, expectations, and sportsmanship guidelines to ensure the safety and well-being of all participants.

  Photo Release Agreement

I grant First Coast Esports Alliance Inc the right to take, use, and publish photographs and videos of the participant during club activities for promotional purposes, including but not limited to newsletters, brochures, websites, and social media platforms. I understand that:

  • No compensation will be provided for the use of such media.

  • All photographs and videos remain the property of First Coast Esports Alliance Inc.


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Participant Name *
Participant Date of Birth *
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Parent/Guardian Name (Use Participant Name if over 18) *
Parent/Guardian Email Address  (Use Participant Email if over 18) *
Street Address *
City
State *
Zip Code *
Emergency Contact Name *
Emergency Contact Relationship *
Emergency Contact Phone Number *
Acknowledgment and Agreement


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