Athletic Registration Form
Please note you must sign up each child individually if multiple children in your household participate. Thank you for understanding!
Student's First Name *
Your answer
Student's Last Name *
Your answer
Grade *
Parent First Name *
Your answer
Parent Last Name *
Your answer
Parent Email *
Your answer
Parent Cell Phone *
Your answer
EMERGENCY CONTACT
If your answer is the same as above click YES and move on to the next section.
SAME AS ABOVE
Name
Your answer
Relationship
Your answer
Cell Phone
Your answer
Home Phone
Your answer
Work Phone
Your answer
HEALTH INFORMATION
Please answer the following questions if it applies to your child.
Condition & Description
Your answer
Current Medications
Your answer
Are there any physical limitations which hinder maximum participation in athletic activities that we should be aware of?
Your answer
My student may have (Check all that apply.)
Please type in your name or initials to serve as your signature for this form. *
Your answer
Thank you for your time!
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