Tampa Youth Empowered in Sports (YES)
Tampa YES  provides opportunity for girls to learn skills and gain experiences that contribute to a more positive lifestyles and enhance their capacity to make healthier life choices physically, emotionally and mentally. 
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STUDENT First NAME: *
STUDENT Last NAME
STUDENT SCHOOL ID # 
(USED AS AN UNIQUE IDENTIFIER)
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Address
Zip Code
School Name
Grade
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PARENT/GUARDIAN NAME
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EMAIL ADDRESS
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CELL NUMBER
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PERMISSION WAIVER

I give my child permission to participate in The Skills Center's Tampa YES program. I understand that my child will participate in in person and/or virtual. 

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EDUCATION DATA

As part of this program, we plan to assess and support your child’s academic success and would like permission to gather the following data when needed during the program about your child from Hillsborough County Public Schools or their charter/private school. We are requesting access to one or more of the following records: report card, progress report, test score, GPA, behavioral, attendance, and/or IEP.

Federal Law (FERPA) requires us to keep educational information about your child private. We will keep your child’s records private by not sharing with anyone outside of our programs, locking/password protected files in file cabinets when not in use. We will only use the educational data for the purposes explained and we will not save any individually identifiable educational data for your child.

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Required

LIABILITY RELEASE

I understand that even when every reasonable precaution is taken, accidents can sometimes still happen. I understand the risk to my child participating in programs in the age of COVID-19 and take full responsibility to ensuring that he/she adheres to the CDC’s safety guidelines on communicable diseases as well as the rules and regulations at The Skills Center. I understand and expressly acknowledge that I release The SKILLS CENTER, INC., as well as all other partners, and their staff members from all liability for any injury, sickness, loss or damage connected in any way whatsoever to participation in The SKILLS CENTER  program activities whether on or off the program and partners’ premises.

I understand that at the discretion of program supervisor and/or staff my child may be dismissed from the program, for inappropriate behavior and displaying symptoms of Covid-19 or other communicable diseases.

I give permission to us photographs and/or video of my child in publications, news releases, online and in other communications related to the mission of The Skills Center Collaborative and its partners.

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EMERGENCY TREATMENT

I understand that if a medical emergency occurs The Skills Center and/or its partners will contact me first, then the emergency contact person designated. If necessary, I authorize the Skills Center to arrange immediate medical treatment for my child’s health and safety. I will be financially responsible for all charges and fees incurred in the rendering of said treatment.

I understand that if my child uses an EpiPen or inhaler, they must bring with them to all programs.  


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Emergency Contact Name *
Emergency Contact Cell Phone *
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