Request edit access
WOODSIDE ATHLETICS PROGRAM CONSENT FORM-VOLLEYBALL
PLEASE COMPLETE THIS FORM FOR EACH CHILD.  CHECKS WILL NEED TO BE SENT TO THE SCHOOL OFFICE.
PLEASE CONSIDER SUPPORTING OUR VOLLEYBALL PROGRAM WITH A VOLUNTARY DONATION OF $180 AND $30 FOR A JERSEY.  Donations can be made via PayPal HERE or via check made out to Woodside School District and dropped at the school office. Receipt of donation payment available if requested. Thank you."
     
Sign in to Google to save your progress. Learn more
AGE AND GRADE OF ATHLETE (SEPARATED BY COMMAS)  (for example: 12, 6th grade) *
FIRST AND LAST NAME OF ATHLETE: *
FALL SPORT VOLLEYBALL: *
Required
GENDER *
Required
BY TYPING YOUR NAME IN THE SPACE PROVIDED, YOU ARE CONFIRMING THAT ALL INFORMATION ON THIS FORM IS CORRECT TO YOUR KNOWLEDGE AND YOU AGREE TO THE FOLLOWING STATEMENT: *
I understand that there are risks present in any and all sports. With full knowledge of this, I am giving my child permission to  participate  in  the  above  named  sport.  I  also  agree  to  abide  by  all  of  the  rules  of  the  team,  the  athletic  department and Woodside School.  Guardian signature needed below:
EMERGENCY INFORMATION *
Please provide the following information: ALL LEGAL GUARDIAN NAMES, and CELL NUMBERS
CONTACT INFORMATION *
Please provide the following information: BEST EMAIL FOR COMMUNICATION
EMERGENCY INFORMATION *
Please provide the following information: EMERGENCY CONTACT (NAME AND CELL NUMBER):
MEDICAL INFORMATION: BY TYPING YOUR NAME IN THE SPACE PROVIDED, YOU ARE GIVING AUTHORIZATION OF THE FOLLOWING: *
I give my authorization to my child’s coach or  appropriate Woodside School official to approve medical treatment  for injuries resulting from either games or practices in the event that either parent or emergency contact cannot be reached. I expect every effort will be made to contact me, my spouse or  emergency contact in order to receive my specific  authorization before any treatment or hospitalization is undertaken. I understand that in an emergency situation it is not always possible to obtain treatment by our specified physician or  hospital. I authorize my child’s coach or appropriate Woodside School official to obtain treatment at the nearest facility if the situation dictates it. Guardian signature needed below:
MEDICAL INFORMATION: *
Any medical or physical restrictions the coaching staff should be aware of:
MEDICAL INFORMATION: *
Family Physician (name and phone number):
MEDICAL INFORMATION: *
Family Hospital (name and phone number):
MEDICAL INFORMATION: As required by Ed. Code sections 315751-315752 *
Medical Insurance Carrier (name and policy ID number):
ADDITIONAL INFORMATION: *
Interested in coaching?
Required
ADDITIONAL INFORMATION: *
Jersey needed ($30 Donation): (Volleyball jerseys are different from basketball)
Required
ADDITIONAL INFORMATION:
If jersey is needed, please indicate size:
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Woodside Elementary School District.

Does this form look suspicious? Report