On this day of 13 August 2089, I do hereby give permission for MELBOURNE ANNIKA JOHANSON to participate in the Dueling Club which will be hosted at Hogwarts School of Witchcraft and Wizardry.

MELBOURNE ANNIKA JOHANSON understands that the club is intended to help develop the necessary skills for successful and safe dueling. However, he/she both also understands that due to the immersive nature of the club, injury is possible and may occur.

MELBOURNE ANNIKA JOHANSON has read the entirety of the Rules and Etiquette of the Club, and agree to all terms and conditions within. He/she also understands that MELBOURNE ANNIKA JOHANSON will be committed to practicing safe and respectful dueling techniques, and will be held accountable for any deviation from the rules of the club and sportsmanship of the duel.

By signing this form, it is understood that MELBOURNE ANNIKA JOHANSON will be enrolled in the Dueling Club and signed into the Dueling Tournament that accompanies the club. Further details as to the nature of the tournament and the club will be disclosed on the first meeting on November 13.

The following information is required about the participant.
Name: Melbourne Annika Johanson
Age: 12
Year: Second
House: Gryffindor
Would Like to Participate In: Meetings and/or Tournament and/or Practice Hall/Assignments/Challenges

Signed, Thunder Ward & India Johanson [Guardian]