Thanksgiving Soccer Camp

EMERGENCY CONTACT INFORMATION

Contact Information should not be the same as Parent/Guardian Information!
EMERGENCY CONTACT (1)*

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Emergency Contact Phone Number*
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EMERGENCY CONTACT (2)*

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CONSENT AND WAIVER FOR MATTIE RHODES CENTER PARTICIPANTS
Please review & check/complete all boxes below.*

REQUIRED! I release Mattie Rhodes Center (MRC) from liability for any injury that may occur on MRC premises, during transportation, or during program participation.I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well-being of myself or my child/dependent.I give MRC my permission to use photographs of my child/dependent or myself taken during programming for MRC marketing use.
Are there any allergies or special medical concerns we should be aware of?*

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If YES, please describe below:
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Participants of all ages are expected to exhibit appropriate behavior. A participant, who displays ongoing in appropriate or unmanageable behavior, including harassment, may be asked to leave the premises or be removed from the group. Please list any behavior or safety issues we should be aware of:*
Mattie Rhodes Center PARENT HANDBOOK

Please TYPE your full name below to acknowledge your review & understanding of the Mattie Rhodes Center PARENT HANDOOK. This contains information regarding: Letter of Understanding (which includes Behavior Support and Interventions), Grievance Procedure, and Notice of Privacy Practices.

Follow the LINK below to access the MRC PARENT HANDBOOK.

PARENT HANDBOOK
Parent/Guardian Name:*

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Thanksgiving Soccer Camp

Ryogoku Soccer Academy & Mattie Rhodes Center after school programs serves kids in Elementary and Middle School. Programming works directly with our youngest grades (Pre-K through 8th).