Contact Name *

First Name

Last Name

Phone Number *

Since this Scavenger Hunt will be using a 3rd party app GooseChase, please enter the phone number which you will be using during the game.

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Participant's Grade Level *

Please check the grade of your LMA student (click more than one grade if applicable).

6th

7th

8th

9th

Parent/Guardian Permission *

As Parent/Legal Guardian, I agree to indemnity and hold harmless Steam Machine Inc., Legacy Magnet Academy, TUSD or any of its agents, contractors, or employees from and against any and all claims, demands, damages, cost arising out of an act of negligence from any incident, injury, or damage to any person or person during which time the student is participating in the program.

I AGREE

Photo Release *

I understand all participants may be photographed and/or videotaped during this event. Names will not be used. These images or videos maybe be used to promote future STEAMachine events and may appear online through STEAMachine's website and/or social media pages.

I AGREE

Signature *

I have read, understand and agree to the terms and conditions of this Program.

I AGREE