BES INTRAMURAL SPORTS REGISTRATION FORM

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TO: Parents of Students in Grades 5 & 6

FROM: Kyrstin Bervert

DATE: October 28, 2025

Intramural sports are offered each year for 5th & 6th grade students to participate in; the fee is $25.00 per year. Our next session is volleyball. If your child is interested in the volleyball session, you will need to fill out the registration form below and submit it with $25.00 (if not already paid during a previous session) to school by Friday, October 31st. (Without this registration form being submitted completely and payment made, your child will not be able to participate). The session will run from Monday, November 3rd through Monday, December 1st. Practice will be held AFTER school every Monday, Tuesday, and Thursday from 4:15pm to 5:15pm for both boys and girls. Participants should be picked up promptly by 5:15pm. ***Exception: There will not be Intramurals on Thursday 11/27 due to Thanksgiving break.

VB Tournament on December 1st from 4:15pm-5:15pm - Parents are welcome to attend.

Each student is responsible for his/her own transportation. Supervision for your non-participating students is not available.

The school district provides insurance for students while they are participating in school sponsored activities. It is a co-insurance with your family policy and the coverage is limited. Please read the certificate of coverage handed out at enrollment.

INTRAMURALS is designed to be a fun program for all levels of physical abilities. This session will offer volleyball activities. This program requires students to exhibit appropriate behavior during the limited one-hour activity. This will allow our coaches and students to cover more of the basic fundamentals of the sport. Students who are unwilling to follow coaches' instructions will not be allowed to continue the program.

Does your student have permission to participate in the Intramurals session of volleyball? *

YES

Child's First Name *

Child's Last Name *

Child's Gender *

Male

Female

Child's Grade *

5th

6th

Child's Teacher *

Mondragon

Hayen

Helmke

Ahlin

Watson

Ward

Parent First Name *

Parent Last Name *

Parent Contact Number *

Emergency Contact First Name *

Emergency Contact Last Name *

Emergency Contact Phone Number *

I understand that the program will start on Monday, November 3rd and run through Monday, December 1st. Practice will be held every Monday, Tuesday, and Thursday AFTER school, from 4:15pm-5:15pm, for boys and girls. ***Exception: There will not be Intramurals on Thursday 11/28 due to Thanksgiving break. *

YES

I understand that the school does not provide transportation for my child, and in order for him/her to participate it will be my responsibility to provide transportation. *

Yes

I understand that Intramurals participants should be picked up promptly at 5:15pm. *

YES

I understand that if my child is consistently being picked up after 5:15pm from Intramurals, my child may be removed from the program. *

YES

I understand the school does not provide supervision of non-participants. *

YES

I understand that the ONE TIME yearly fee of $25 for Intramurals will need to be sent to the school office, or paid over the phone via credit/debit card, prior to my child starting the program. *

YES

Parent Signature: Typing your name below stands for your signature and permission for your child to participate in the Intramurals session of volleyball. *

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