SURVIVOR GAMES

What is Survivor Games?

Survivor Games offers physical activities and mind games to children’s groups. There are 3 children in each group, and they will face challenges and see how well they strategize with their team members. At the end of each game, the groups will score points and the two groups at the bottom of the scoreboard will enter the knockout pot. However, if one of the last two teams wins the protection game, it does not enter the elimination pot. Groups in the elimination pot will be eliminated one by one by the votes of the other groups.

Purpose

The effects of physical games on brain health may explain improvements in academic performance. This project is aimed to increase the academic success of the target audience through socialization with their peers.

Intelligence and mind games, which are part of Survivor Games, are effective in developing students’ problem solving, reasoning, self-regulation, communication and three-dimensional thinking. In addition to such skills, it helps students develop intelligence types such as linguistic, mathematical, visual, and social intelligence.

Survivor Games Registration Form

Team Name

Name

Student's Grade

Address

Student's Phone Number

Student's Email

Parent's Email

1st Parent/Guardian Name

1st Parent/Guardian Phone

1st Parent/Guardian's Place of Work

1st Parent's Work Phone

2nd Parent/Guardian Name

2nd Parent/Guardian Phone

2nd Parent/Guardian's Place of Work

2nd Parent's Work Phone

Emergency Contact

Relationship

Phone

Child resides with

Name and phone number(s) of person(s) other than parents allowed to pick up your child (Separate with comma):

Any speacial instructions, such as custody or restraining orders must be attached to this application and discussed personally with the director of event organizer. All information will be kept confidential.

Please list any other information you'd like to include about your child:

Parent Authorization Form

Platform for Leisure and Achievement of Youth does not discriminate based on race, color, sex, handicap, religion or national origin. The Intercultural Dialogue Institute reserves the right at its sole discretion to refuse an application or dismiss a child from campsurvivor games. No refund will be made of fees if the child has attended any portion of the survivor games.

I understand and accept these guidelines

I give Platform for Leisure and Achievement of Youth permission to photograph and/or videotape my child for public relations and/or marketing purposes. Photos will remain archived at Intercultural Dialogue Institute and can be used for promotional purposes without notification.

I give permission for Platform for Leisure and Achievement of Youth to transport my child for the purpose of field trips and/or medical care. I understand that a schedule of events will be available to me and that all events are subject to change due to weather and/or scheduling conflicts without notice.

I authorize the management to act as the agent of the parents in any emergency situation or to administer basic first aid for the health and welfare of the children involved. I am responsible for the expenses involved if the services of a physician or hospital are required. Please request a waiver for persons requesting exemption from medical treatment.

Preferred Hospital

By checking here I agree to adhere to all the Policies and Procedures set for by Platform for Leisure and Achievement of Youth.

Student's Medical Information Form

The medical background of each child is required as part of the project’s registration process. The project coordinator must be advised in writing of any condition that would limit the child’s ability to participate in any program.

Child's Name

Date of Birth

Child’s Pediatrician’s Name

Pediatrician's Phone Number

Date of Last Physical

Date of Last Tetanus Shot

Medical Conditions

List of Past Medical Treatments (Separate with comma)

List all current medications regardless of whether it needs to be taken a parkour or not(Separate with comma)

Will your child need to take any prescription medications while at competition?

If yes, please request a medical dispensing form. Return the form and medication in a zip lock bag with your child’s name on it on the first day that they attend the competition

Allergies

Please put NA if your child have no allergy

Food

Medication

Insect

Other

Does your child require an Epi-pen?

If yes, you must provide the competition with an Epi-pen to be kept at competition during your child’s enrollment. Epi-pen must be accompanied with a current prescription and a doctor’s note.

Specific Activities to be restricted for health reasons