Haven Gaming Interest Form
Member Name
*
First Name
Last Name
Membership Number
*
Email Address (Parent)
*
example@example.com
Gamer Name
*
First Name
Last Name
Gamer Date of Birth
*
-
Month
-
Day
Year
Date
Gamer Gender
*
Male
Female
Prefer Not to Say
Gamertag – (Optional, can be set up at time of first reservation. We advise picking something easy to remember, as it will be used to log into our system)
Membership Level
*
Core
Academy
Which team are you interested in joining?
*
Super Smash Bros. Ultimate
Minecraft
Battle Royale/FPS (Includes games such as Fortnite, Overwatch, and Apex Legends. All titles will be rated T for Teen or lower)
Are you interested in participating in the Haven LVL Up Program? (Included with all membership levels with no additional fee. Can be opted back into.)
*
Yes
No
What do you primarily game on?
*
PC
Console
Mobile
What games do you primarily play?
*
Are there any other titles you would be interested in joining a Haven Academy team for?
*
Submit
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