Esports Interest Form

Bridge Gaming: Bridge Leadership Academy’s New Esports Team
We are excited to launch our 2nd year of a new program within Bridge Leadership Academy: an Esports Team. Bridge Gaming focuses primarily on 12-17 year olds interested in competitive gaming, while also learning valuable life skills such as teamwork, leadership, self-control, communication, and more. We hope this program will help students not only transition to other Esports teams in high school and college, but also transform their lives holistically. The benefits of sports in young people’s lives is well known, but we see that students with physical limitations or a lack of interest in standard sports (football, baseball, etc) can miss out on the comradery and lessons that come with competing. We hope this program will provide a safe, fun environment where students can grow their problem-solving, social/emotional, and technical skills. This is a brand new program that we are hoping to build with the help of our community. If your child is interested in being a part of this program, please register by filling out the information below.

When: We meet on Tuesdays and Thursdays, weekly, from 4-6pm. Dinner is provided at each meeting. Dinner will be provided from 4-4:30. If your student shows up past 4:30, we may not be able to provide a meal for them.

Where: The Bridge Leadership Academy building: 10521 Blue Ridge Blvd, Kansas City, MO 64134

Your student will need consistent transportation to and from our building.

All students must be signed in and signed out by their parent or guardian.
Basic Information
Student Name*

First NameLast Name
Parent Name*

First NameLast Name
Parent Email*
example@example.com
Student School Email (optional)
example@example.com
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent Phone*
Please enter a valid phone number.
Student's Date of Birth*

MonthDayYear
Date
What grade is your student in?*
What school does your child attend?*
What shirt size does your student wear?*
Please specific if it is a Youth or Adult size.
Please list any accommodations or special needs your student may need in order to participate.
Note: we do not discriminate based on special needs or disabilities and your response to this question will not affect your opportunity to participate in our Esports program.
Gaming Experience

These questions are directed toward your student.
How many years have you been playing video games?*
What consoles do you primarily play games on?*
Examples: Xbox Series X, PC, PS5, etc
What are your favorite 3 games to play?*
Please note that games that are rated Teen or Mature (or higher) will be reviewed by the Bridge team and each student must receive written permission from their parent/guardian to play them. In general, Bridge Gaming will look to exclude games rated Mature.
How many hours per week do you spend playing video games?*
Do you have any competitive gaming experience?*
If yes, please elaborate.
Example: competed at Park University in 2023 and placed 3rd.
Optional: what's your gaming name?
Gamer tag or username.
What are your goals when competing/playing?*
In other words, why do you play video games?
Why do you want to be a part of this program?*
I understand that my student's involvement in this program is determined by their behavior and academic performance. The Bridge Leadership Academy can choose to remove any student from the program if they do not meet academic and behavioral standards.*

I understand
I understand that dinner will be provided from 4-4:30. Any student arriving past 4:30 may not receive a meal.*

I understand
I understand that my student must be transported to and from the Bridge building on time and prepared for the session. Drop off is 4:00-4:15pm and pick up is 5:45-6:00pm.*

I understand
Parent Signature*

Powered by Jotform SignClear
Should be Empty:

Bridge Gaming: Bridge Leadership Academy’s New Esports Team

Basic Information

Gaming Experience