BCHS Athletic Eligibility Form-PART II 2018-19
Bishop Chatard REQUIRES information and consent to be submitted by parents and students for athletic eligibility each school year. This form should be completed in the presence of Parent AND Student(s)--THERE ARE 2 PARTS to SUBMIT:

PART 1: The IHSAA Pre-Participation Physical Evaluation Form MUST BE PRINTED from our web site and received as hard copy only. The IHSAA form includes a page that a PHYSICIAN ONLY ( NP signature not accepted) must complete. Physical must be completed on/after April 1, 2018

PART 2: This electronic document fulfills requirements including:
* Code of Conduct
* Travel Authorization
*Concussion and Sudden Cardiac Arrest Acknowledgement
* St Vincent Sports Performance- Consent for Athletic Training Services


Please complete these questions to complete PART 2- for Athletic Eligibility in Bishop Chatard Athletics for 2018-19 yr.
Complete all pages then SUBMIT button. ONE submission per FAMILY is sufficient if all kids are listed.

Student Athlete #1 LAST Name *
Your answer
Student Athlete # 1 (FIRST Name, Year of Grad) *
Your answer
Student Athlete # 2 Name ( LAST, First, Year of Grad)
Your answer
Student Athlete # 3 Name ( LAST, First, Year of Grad)
Your answer
Student Athlete # 4 Name ( LAST, First, Year of Grad)
Your answer
1st Contact Parent Name *
Your answer
Address, City, Zip *
Your answer
1st Contact Cell Phone *
Your answer
Parent/Guardian Email *
Your answer
Parent/Guardian # 2 Cell Phone
Your answer
Parent/Guardian # 2 Email
Your answer
Emergency Contact Name/Phone Number *
Your answer
Preferred Hospital *
Your answer
Next
Never submit passwords through Google Forms.
This form was created inside of Bishop Chatard High School. Report Abuse - Terms of Service - Additional Terms