Fourth Universalist Society Dungeons and Dragons for Youth Permission Form (2021-2022)
Welcome! Thank you for your interest in our Dungeons and Dragons program at the Fourth Universalist Society in the City of New York!

Use this form to sign up Children and Youth for our 4th Universalist Dungeons and Dragons Playgroup.

Please fill out a separate form for each child being registered, even from the same family.

We invited 1st and 2nd Grade Students to join with help from parents in handling the complexities of gameplay. 3rd Grade and up are invited to join us on their own.

We will be meeting starting on May 21st, 2021, alternating weeks. Running from 6pm to 7:45pm. It will be hosted on Zoom until return to in person.  We understand that young people may not be able to make it to every session, but encourage consistency.
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Email *
Registrant (Child or Youth) Name *
Registrant Age and Grade   *
Parent(s) or Guardian(s) Name(s) *
Parent(s) or Guardian(s) Phone Number(s): *
Parent(s) or Guardian(s)  Email Address(es) *
We want to make sure our program is both welcoming and accessible, so please share with us any special needs or allergies for our staff to be aware of in providing a safe and nurturing environment for your child:
Anything else (interests, personal context, pronoun preferences) you'd like us to know to help us make this program a great experience for your children and family?
By signing my child or youth up for RE I understand and/or grant permission for the following program elements:
There will be two unrelated, background-checked adults present at all times per online classroom, including for live children's programming outside of the regular Sunday morning classes.

No recordings or images of any child(ren) or youth will be made or re-shared via any online platform without parent or guardian permission. Situations in which this may occur include special services or promotional materials.  

For online programming, parents and guardians are responsible for the attire, health, and behavior of the enrolled child(ren) or youth, since remote learning limits instructor ability to direct these aspects of the classroom experience. Instructors will moderate participation with the powers made available to them via the platforms in use (muting, admitting participants, etc.), but the church is not responsible for any unanticipated breaches of behavioral expectations.

For this specific event, I grant permission for my child to join in playing Dungeons and Dragons together with a group of registered children and volunteers. Dungeons and Dragons involves imagination,fantasy, role playing, fighting, engaging in dialogue, and other exploratory elements. While the volunteers guide the gameplay as “dungeon masters”, I acknowledge that there is some level of unpredictability. The volunteer adults present will be prepared to step in as needed if additional supervision is needed.

For 1st and 2nd Grade Students, we ask that a parent be present with them on Zoom to help guide them through any complexities of play. 3rd Grade and up do not require any additional supervision unless requested by the leaders.

Once you have signed and submitted this form, you will have successfully registered for our program, and we are delighted to have you.
Parent / Guardian 1 Name (will serve as e-signature): *
Parent / Guardian 2 Name (will serve as e-signature):
Welcome to Fourth Universalist Dungeons and Dragons and see you soon!
A copy of your responses will be emailed to the address you provided.
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