Parent Permission for Participation
Please provide a parent/legal guardian email address on this form.
Email address *
Activity *
Student Code of Conduct
WEBER SCHOOL DISTRICT
5320 SOUTH ADAMS AVENUE
OGDEN, UTAH 84405

Dear Parent:

The junior high school athletic program of the Weber School District is again being conducted this year.

With the welfare of all concerned in mind, we are requesting that the procedures listed below be followed before your son/daughter will be eligible to participate in the athletic program.

Your digital signature will be interpreted to mean that you have complied with each one of the following items:

That you have given consent to having your son/daughter participate in the athletic program and to travel to and from other schools for this purpose.

That he/she has been examined by a physician licensed in the state of Utah and has been found physically acceptable to participate. A signed statement from the physician must be provided to the school. This must have taken place within a 12 month period prior to the sport in which the student is participating.

3. That you have given emergency medical authorization at your expense for transportation and/or treatment by a physician or hospital when the parents/guardian are not available.

That he/she is covered by insurance. (See question below)

That you are aware that there are eligibility requirements for participation and that your son/daughter will comply with and meet those requirements or will not be allowed to participate.

You further certify by digitally signing below that you agree that any claim or dispute arising out of injuries sustained while participating in these activities shall be settled by binding arbitration administered by the American Arbitration Association under its commercial arbitration rules, and judgment on the award rendered by the arbitrator(s) may be entered in any court having jurisdiction thereof.

Student First Name (Please capitalize the first letter with the rest lower case i.e. John) *
Your answer
Student Last Name (Please capitalize the first letter with the rest lower case i.e. Smith) *
Your answer
Parent/Legal Guardian First Name *
Your answer
Parent/Legal Guardian Last Name *
Your answer
Insurance
Insurance Notice and Waiver
Participation in inter-scholastic athletic competition comes with inherent risks. Students who participate in such activities assume these risks voluntarily. Students are strongly encouraged to be covered by health and accident insurance that covers injuries sustained while traveling to and from inter-scholastic athletic events, during practice, or during an event. Student injuries that occur as a result of participation in inter-scholastic athletic competition are NOT covered by a Weber School District’s insurance policy.
By having your student participate in Weber School District inter-scholastic athletic competitions, you acknowledge your understanding that Weber School District will not cover student injuries inherent in such competitions. You further warrant and acknowledge and waive any right to assert a claim against Weber School District or North Ogden Junior High School for any medical, doctor, or hospital bills and expense resulting from injuries sustained by your student in the normal course of participation in inter-scholastic athletics.
I acknowledge my understanding that Weber School District will not cover student injuries inherent in inter-scholastic athletic competitions and waive any right to assert a claim against Weber School District or associated school for medical, doctor, or hospital bills or expenses resulting from such injuries
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A copy of your responses will be emailed to the address you provided.
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