Stargate Middle School Summer Fitness Fun
The fee for participation is $75 which includes all 28 training sessions.

Fees will be assigned to the student's Infinite Campus account and must be paid on payforit.net BEFORE the first day of training, which will be June 4th, 2018.

Summer Fitness Fun is open to any Stargate middle school student who wishes to attend (athlete or not)

Training sessions:
June: 4,5,6,7,11,12,13,14,18,19,20,2125,26,27,28
July: 9,10,11,12,16,17,18,19,23,24,25,26

Student First Name *
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Student Last Name *
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Grade (2018-2019 school year) *
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Gender *
Age *
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Sports played *
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Parent/Guardian
Please indicate primary parent/guardian for contact information
Parent/Guardian First Name *
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Parent/Guardian Last Name *
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Preferred Parent/Guardian Cell Number *
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Preferred Parent/Guardian Email *
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Health Information
Permission for Medical Treatment *
Please Read and Electronically Sign below to the Following Statement: In the event of an emergency requiring mediacal attention, I hereby grant permissions to a physician or hospital personnel to attend to my son/daughter. Every effort will be made to contact me in order to receive my specific authorization before any treatment or hospitalization is undertaken.
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Health Information
Please list any significant or on-going health conditions relevant to school or athletics (severe allergies/epi-pen, asthma, diabetes, epilepsy, heart disease, vision or hearing problems, medications, etc.) Please enter N/A for no health issues.
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Insurance Waiver *
Required
Parent Digital Signature *
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WARNING TO PARENTS AND STUDENTS *
By its very nature, participation in strength and conditioning may put students in situations in which SERIOUS, CATASTROPHIC and perhaps, FATAL ACCIDENTS may occur. Many forms of athletic competition result in violent physical contact among players, the use of equipment which may result in accidents, strenuous physical exertion, and numerous other exposures to risk of injury. Students and parents must assess the risks involved in such participation and make their choice to participate in spite of those risks. No amount of instruction, precaution, or supervision will totally eliminate all risk of injury. Athletic participation by students also may be inherently dangerous. Athletes have the responsibility of reporting their injuries/illnesses to their parents and coaches. I also understand that by participating in my sport there is a possibility that I could suffer a head injury/concussion. I understand the importance of immediate reporting of symptoms to my parents and coaches. By granting permission for my student to participate in athletic competition, I acknowledge that such risk exists. I hereby give my consent for my son/daughter to compete in Stargate athletics and I have read and understand this form.
Required
Parent's Digital Signature *
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Student's Digital Signature *
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Stargate Field House and Training Facility
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