PREMIER SPORTPLEX
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Summer Camp
Special Events
Volleyball
Tournaments
Extra Touches
Youth Leagues
Club Volleyball
Open Gym
Lab School Pre-k-12th
MOTHERS DAY OUT
Birthday Parties
Contact
Basketball
Homeschool Opportunities
Partners
Premier Power House
Futsal
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
Summer Camp
Special Events
Volleyball
Tournaments
Extra Touches
Youth Leagues
Club Volleyball
Open Gym
Lab School Pre-k-12th
MOTHERS DAY OUT
Birthday Parties
Contact
Basketball
Homeschool Opportunities
Partners
Premier Power House
Futsal