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Mohave Community College
MCC Community Education
MCC Community Education
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Notes/Comments
For All Minor Students
Parent/Guardian Name:
Parent/Guardian Email:
Parent/Guardian Phone:
Any medications that your minor student(s) requires are solely the responsibility of parent or guardian. At no timewill MCC staff or faculty administer any medications to minor students.
Initial
A sign-in and sign-out process will be in place for classes with minor students. Parents or guardians must come to the designated sign in room to sign their student into the class – no drop offs are allowed. Students will be held until the authorized adult signs out the student. Only persons on the authorized list will be allowed to take students from the premises.
Initial
I understand that if my minor student(s) presents a discipline problem to the extent that they disrupt the class, the authorized adult will be notified and the student sent home with that authorized adult immediately. A second occurrence of a discipline problem will result in expulsion from the program and no refund will be offered.
Initial
Photos may be taken of your minor student(s) for publication purposes. You may opt out of these photos by placing an X in the initial space. Otherwise, please initial where indicated.
Initial
Allergies, if any, we should know about:
In the event of an emergency or crisis event where the Campus Crisis Management Plan is called into play, program participants including parent or guardian are expected to follow crisis management team instructions.
I give permission for the above named minor student(s) to enroll as a student at Mohave Community College (MCC) Community Education course(s). I understand that this permission, once given, may not be revoked during their enrollment period at MCC. Further, I understand MCC policies, rules, and regulations, and the statutory laws surrounding enrollment for minor student(s) and agree that my minor student(s) and myself will follow these policies, rules, and regulations to the fullest extent regarding minor student(s).
Legal Parent or Guardian Signature (type full name):
Release of Liability Agreement
Checking the box signifies that any person(s) listed above have read the terms and conditions on this
Voluntary Assumption of Risk and Release of Liability
form for participation in this course(s), and that I acknowledge that I understand it and agree to abide by them. No representation, statements, or inducements, oral or written, apart from the foregoing written statement, have been made. This
Voluntary Assumption of Risk and Release of Liability
form shall be governed by the laws of the State of Arizona that shall be the forum for any lawsuits filed under or incident to this form or to the course. If any portion of this form is held invalid, the rest of the document shall continue in full force and effect.
Pay & Enroll
After you click this button, you will see a copy of your receipt and will also receive one in your e-mail.