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Media 360

Parental Consent Form for M-rated Games

 

 

 

Media 360 supports the ESRB industry rating system for video games and the voluntary enforcement of this rating system. Any customer who is not at least 17 years of age is prohibited from playing Mature (M) rated games on our Local Area Network. Titles rated Mature (M) have content that may be suitable for persons ages 17 and older. These products may include more intense violence or language than products in the Teen (T) category.

Full Disclosure, Informed Consent to Participate, and Liability Release:

I am the parent and/or legal guardian of ________________________________,
who is ____ years of age. I am aware that the above named minor will be playing video games that have an industry rating of Mature (M). I am aware that this rating indicates that the content of the video game may not be suitable for children less than 17 years of age.

By my signature, I grant my permission to allow the above named minor to play Mature (M) rated games featured on your Local Area Network.  I perpetually release Media 360, its employees and sponsors from any and all liability that may arise from my decision of allowing a minor to play M-rated video games.

Signature of Parent or Legal Guardian (required)

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Print Name of Parent or Legal Guardian (required)

 
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Address of Parent or Legal Guardian (required)

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Telephone Number of Parent or Legal Guardian (required)

 

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Date

 

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