PIEA Membership Registration

School *

Esports/School Logo

School Mascot/Team Name *

School District *

School Address *

Address Line 2

City *

State *

Zip Code *

Do you have an official esports club, team or program at your school? *

Yes

No

Other Other

Games of Interest *

Estimated Number of Participants *

Team Manage/Coach/Advisor Contact

First Name *

Last Name *

Title *

Email Address *

Discord Name *

Phone Number *

Terms and Conditions *

You consent to receive communications from us electronically. We will communicate with you by e-mail or phone. You agree that all agreements, notices, disclosures and other communications that we provide to you electronically satisfy any legal requirement that such communications be in writing.

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