RV Intramurals Parent Pick Up Info (Fall 2023)

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PLEASE COMPLETE THIS FORM

Thank you for your cooperation in this matter. We know you understand that for the safety and well-being of your child, it is essential that children are picked up on time by the appropriate people.

Intramurals Times: 2:45pm-3:30pm in the Riverview Gym Pick up Time: 3:30pm

This form must be completed for you child to participate in intramurals.

Child's Name: *

Parent's Name: *

Home or Cell Phone: *

Emergency Phone: *

Grade: *

5th grade

6th Grade

Homeroom Teacher *

Please tell me how your child will be getting home. *

I will pick my child up at 3:30pm when intramurals ends.

I authorize my child to walk home.

My child is a Youth Center member and will go there.

My child will ride home with another parent.

Name of alternate parent taking your child home. *

Phone number of alternate parent taking your child home. *

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