DJDS Upper Division Sports Sign Up and Permission Form - 2018-19
Email address *
By signing this Permission Form we (parent/guardian and student) acknowledge that we have read and understood the information below. Parents/guardians or students who do not accept the risks described below should not sign this Permission Form. This, however, means that the student would not be able to participate in the sport.

All students participating in inter-school athletics must have a form on file at school signed by a practicing physician certifying that he/she has passed an adequate physical examination within the past year; that in the opinion of the examining physician, he/she is physically fit to participate in high school athletics.

I hereby give consent for my child (named below on this form) to compete in Denver JDS extracurricular athletics. I understand that the participation fee of $165 for middle school and $175 for high school will be billed to my Smart Tuition account.

Student First Name *
Your answer
Student Last Name *
Your answer
Grade *
I am currently signing my child up for the following sport: (selection box with the sports listed below) *
Fee will be billed to your Smart Tuition account
Warning: Although participation in supervised interscholastic athletics and activities may be one of the least hazardous ways in which a student will engage in or out of school, by its nature, participation in interscholastic athletics includes a risk of injury, which may range in severity from minor to long-term catastrophic. Although serious injuries are not common in supervised school athletic programs, it is impossible to eliminate the risk.

Participants have the responsibility to help reduce the chance of injury. Players must obey all safety rules, report all physical problems to their coaches, follow a proper conditioning program, and inspect their own equipment daily.

No pupil shall represent his/her school in inter-school athletics until there is on file with the school a statement signed by his/her parents or legal guardian and a practicing physician certifying that he/she has passed an adequate physical examination within the past year; that in the opinion of the examining physician, he/she is physically fit to participate in high school athletics; and that he/she has the consent of his/her parents or legal guardian to participate. A student who has received an adequate physical examination at least once upon entering high school may elect to have a Medical Re-evaluation instead of a physical examination in subsequent years, unless a significant injury or illness has occurred during the past year.

NOTE: It is strongly recommended by the Colorado Department of Health that individuals participating in athletic events have a current tetanus booster.
• A tetanus booster is recommended every 10 years throughout life.
• A tetanus booster if recommended at the time of injury if more than five years have elapsed since the last booster.

If a significant intervening illnesses and/or injuries have occurred, a more complete physical examination should be conducted. The physical examination must be documented by a practicing physician.

If a student athlete has been injured in practice and/or competition, the nature of which required medical attention, the student athlete should not be permitted to return to practice and/or competition until he/she has received a release from a practicing physician.

NOTE: The CHSAA urges an adequate physical examination be given when a student athlete changes levels of competition, i.e. Little League to Junior High, Junior High to High School, etc.

Parent/Guardian’s Signature (type name in box below to serve as signature) *
I (parents and/or guardians) understand that Denver JDS is not liable for any loss, damage of property or personal injury as a result of student's participation in sports.
Your answer
Date *
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Student's Signature (type name in box below to serve as signature) *
Your answer
Date *
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