MVA Athletic Registration 2017-18
Please fill out the following information below. If you have multiple children involved in Athletics you will need to fill out separate forms for each. All information collected by this form will be confidential, will not be shared with any outside third party, and will be used only for the purpose of meeting WIAA and DPI requirements for students to participate in athletics. Parents still have the option to fill out hard copies of each required document, which includes the following: Athletic Permit, Concussion Form, WIAA Eligibility Form, and MVA Athletic Code. Completing this online form fulfills the requirements of all of the above forms. Your child may still need a Physical. Any questions please contact Curt Miller, Athletic Director at 715-443-2226 x4303 or cmiller@marathon.k12.wi.us.
Email address *
Parents First Name *
Your answer
Parents Last Name *
Your answer
Students First Name *
Your answer
Students Last Name *
Your answer
Students Grade *
Students Date of Birth *
MM
/
DD
/
YYYY
Students Current Age *
Your answer
Sports the student intends to participate in (please list all) *
Your answer
Present Address *
Your answer
Parents Telephone (best contact number) *
Your answer
Parents Email *
Your answer
Parents Place of Employment *
Your answer
Family Physician *
Your answer
Family Dentist *
Your answer
Name of Private Insurance Carrier *
Your answer
Insurance Carrier Telephone *
Your answer
Subscriber Member Name (Primary Insured) *
Your answer
Next
Never submit passwords through Google Forms.
This form was created inside of Marathon City School District. Report Abuse - Terms of Service - Additional Terms