Hill Athletic Participation Agreement
2017 Boys Basketball Season - Parents/guardians complete a form for each athlete participating in athletics at Hill Middle School. Please provide an email address below to receive a confirmation of completion and a copy of our athletic code of conduct, concussion waiver, and our school policies that all athletes must follow for the duration of the season.
First Name (Student)
Last Name (Student)
Parent/Guardian Full Name
Parent/Guardian Cell Phone
Optional 2nd Cell Phone
Emergency Contact Phone
Is a current physical exam on file with the school nurse?
All students trying out/practicing for a sport must have a current physical exam on file with the school nurse. A current physical exam is one that has been completed within THIRTEEN months of the last day of the season. Physicals are valid for one calendar year.
Not Yet, but we are working on it
Medical concerns to be shared with the coaches.
If your child has an inhaler, they are required to have it with them at practice at all times
Is your student covered under a school insurance policy?
No, See below
If not, your digital signature constitutes a waiver and a confirmation of other insurance coverage. Either home or school medical insurance is required.
Please include the insurance company and the policy number:
Hill Middle School Athletic Code of Conduct
Parent/Guardian and athletes are asked to and read the following guidelines and submit an electronic commitment to your school, administrators, and coaches. In doing so, you are acknowledging that you have read and will comply with these guidelines and policies. Click on the link to view the athletic code of conduct:
Yes, I have reviewed the following athletic code of conduct and I acknowledging that I have read and will comply with these guidelines and policies.
Concussion From Acknowledgment
Click the follow link for the district concussion policy and read through the material. In doing so, you are acknowledging that you have read and will comply with these guidelines and policies.
Yes, I have reviewed the following Concussion Sign Off Form and I acknowledging that I have read and will comply with these guidelines and policies.
I understand that I am responsible for transportation home from school at 5:00 P.M.
Please note that daily practice ends at 4:50 each day. You should plan to pick up your child from practice at that time. (Allow 5-10 minutes for them to get changed) If transportation can not be arranged by 5:00, athletes should not attend practice that day.
Yes, I understand
Athletic Fees ($125.00 per sport)
Athletes are asked to pay a $125.00 fee per sport ($250.00 for two or more). Please do NOT make a payment until your athlete has made the A or AA team. Complete 1 of the payment options listed below. Athletes that do not make a payment by the first game will not get a team uniform and will not participate in games until a payment has been made.
1. Pay the $125 fee for this sport online through PushCoin (the same place I can pay for school lunch).
2. Pay by check (payable to Hill Middle School with your phone number and the student's ID#)
3. Pay with cash
Should you have any questions or concerns, please contact our main office.
Digital Signature of Parent/Guardian - Please type in the first and last name of the parent/guardian that is filling out this form. This constitutes written permission to participate in the Middle School Athletic Program and understanding of the inherit risk involved.
While participation in athletics provides student athletes with valuable and constructive experiences of both a social and physical nature, it must be remembered and understood normal participation in games and practices may also bring the possibility of serious injury. While every precaution is taken to safeguard athletes from injury, a certain amount of risk is inherent in athletic participation
A copy of your responses will be emailed to the address you provided.
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