PREMIER SPORTPLEX
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Volleyball
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OPPS Pre-k-12th
MOTHERS DAY OUT
Birthday Parties
Homeschool Opportunities
Basketball
Futsal
Special Events
Contact
Please email or call to confirm availability before enrollment.
Rise and Shine Director, Marissa Lemmert 405-202-6225 or
[email protected]
BASIC INFORMATION
*
Indicates required field
Child's Name
*
First
Last
Date of Birth
*
Primary Guardian 1
*
First
Last
[object Object]
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Email
*
Primary Guardian 2
*
First
Last
[object Object]
Phone Number
*
Email
*
Emergency Contacts / Permission to Pick Up:
Name
*
First
Last
Phone Number
*
Relationship
*
Name
*
First
Last
Phone Number
*
Relationship
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Health Information
Physician's Name
*
First
Last
Phone Number
*
Special Health Needs/Allergies
*
Photo Release
I give permission for Rise and Shine to use photographs of our child(ren) on the SportsPlex website and /or any fliers, brochures, or any other publication relative to Rise and Shine
Choose One
*
yes
no
Consent to Treatment
I understand every effort will be made to reach me int he event of an emergency. If I cannot be reached, I give permission for the Director(s) of Rise and Shine to act on my behalf of my child to receive medical care. I authorize and consent to medical, surgical, and hospital care to be performed for my child by medial staff to safeguard my child's health. I waive my right of informed consent to such treatment. I also give permission for my child to be transported by ambulance if needed.
Choose One
*
Yes
No
Which days will your child be attending
*
Tuesdays
Wednesdays
Thursdays
Submit
Home
Volleyball
Club Volleyball
Youth Leagues
Clinics
Fast Fours
Open Gym
OPPS Pre-k-12th
MOTHERS DAY OUT
Birthday Parties
Homeschool Opportunities
Basketball
Futsal
Special Events
Contact