Chestertown Christian Academy                     Athlete Participation Packet 2026-2027
The CCA Athlete Registration Packet must be submitted for each student athlete before the first game of the season. The packet includes the following:
  • Athlete Registration and Agreement
  • Permission to Travel and Medical Consent
  • Concussion Form
  • Athletic Handbook Agreement
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ATHLETE REGISTRATION
Name of student:
 *
Date of birth *
Age  *
Address  *
Mother/Guardian Name *
Mother/Guardian Email *
Mother/Guardian Cell Number *
Father/Guardian Name *
Father/Guardian Email *
Father/Guardian Cell Number *
Emergency Contact Name (other than mother/father/guardian) *
Emergency Contact Relationship to Student *
Emergency Contact Cell Number  *
Please list any medical conditions the student may have.  *
Primary Care Physician and Phone Number *
ATHLETE AGREEMENT: 
By signing this form, you and your student have read and agree to the terms and conditions of the athletic forms of Chestertown Christian Academy. 

Terms and Conditions: I do hereby allow my student to participate in any practice, game, or function sanctioned by Chestertown Christian Academy. I accept full responsibility for any liability and release Chestertown Christian Academy, Its employees, its coaches and volunteers from any financial responsibility due to injury or otherwise. If I cannot be contacted in the event of injury or illness of my child during practice, transportation or a game, I hereby give my permission for the coach or designee to administer first aid or medical attention from a doctor, nurse or emergency center.
PARENT/GUARDIAN: PLEASE TYPE NAME TO AGREE TO THE ABOVE TERMS AND CONDITIONS.
 *
PERMISSION TO TRAVEL & MEDICAL CONSENT: 
With the increasing sophistication of our medical systems, we are finding it expedient to have a release on file from a parent/guardian in the unlikely event of some serious injury requiring medical treatment. This release authorizes Chestertown Christian Academy to take your child to the nearest available medical facility and have the medical attention we deem necessary, administered. This release is necessary, as many hospitals will not administer any medical attention to a minor without some form of consent from a parent/guardian. This release also authorizes Chestertown Christian Academy to transport your student to and from athletic events including practices and games. Therefore, please read the following statement and sign below if you provide consent: I GIVE MY STUDENT, PERMISSION TO GO TO ANY OR ALL GAMES/EVENTS IN RELATON TO CHESTERTOWN CHRISTIAN ACADEMY (CCA) VIA TRANSPORTATION PROVIDED BY COACHES, PARENTS, OR BUS. I DO HEREBY RECOGNIZE THAT CCA, ITS DIRECTORS, EMPLOYEES, AND AGENTS WILL NOT BE HELD LIABLE FOR ANY UNFORSEEN AND/OR UNFORESEEABLE ACCIDENTS OR INJURIES THAT MAY OCCUR DURING THE COURSE OF THE SAID MINISTRY/ACTIVITY. I RELEASE CCA, ITS DIRECTORS, EMPLOYEES AND AGENTS FROM ANY LIABILITY FOR PERSONAL INJURY DUE TO WILLFUL DISREGARD ON THE PART OF MY CHILD TO FOLLOW SAFETY RULES AND REGUALTIONS. IN CASE OF EMERGENCY, I UNDERSTAND THAT EVERY EFFORT WILL BE MADE TO CONTACT ME. IF I CANNOT BE REACHED, I HEREBY GIVE CCA PERMISSION TO ACT ON MY BEHALF IN SEEKING EMERGENCY TREATMENT FOR MY CHILD. IN THE EVENT THAT SUCH TREATMENT IS DEEMED NECESSARY BY CCA. I GIVE PERMISSION TO THOSE ADMINISTERING EMERGENCY TREATMENT TO DO SO, USING THOSE MEASURES DEEMED NECESSARY. I ABSOLVE CCA, ITS DIRECTORS, EMPLOYEES, AND AGENTS FROM LIABILITY IN ACTING ON MY BEHALF IN THIS REGARD. THIS CONSENT IS FOR THE 2025-2026 SCHOOL YEAR. 
PARENT/GUARDIAN: PLEASE TYPE NAME TO GIVE CONSENT.
 *
CONCUSSION FORM:
I acknowledge that I have read the information from the Concussion Fact Sheet, and have discussed it with my student athlete. For more information on concussions, visit: www.cdc.cdc.gov/Concussion.   PARENT/GUARDIAN: PLEASE TYPE NAME TO GIVE CONSENT.

ATHLETIC HANDBOOK AGREEMENT: 

By signing below, I acknowledge that I have received, read, and understand the Chestertown Christian Academy Athletic Handbook.

I understand that participation in the athletic program is a privilege and that student-athletes are expected to uphold the standards, expectations, and policies outlined in the handbook. I agree to support these expectations and understand that failure to comply may result in disciplinary action, including suspension or removal from athletic participation, as determined by the school administration and athletic department.

As the parent/guardian of the student-athlete, I agree to support the mission and values of Chestertown Christian Academy and to encourage positive sportsmanship, respect for coaches, officials, teammates, opponents, and school policies.

By electronically signing this acknowledgment, I certify that I have read the Athletic Handbook located here, have had the opportunity to ask questions regarding its contents by emailing the athletic director at athleticdirector@chestertownchristian.org, and agree to abide by its policies and procedures throughout the athletic season.

PARENT/GUARDIAN: PLEASE TYPE NAME TO GIVE CONSENT.

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