CENTRAL
JUNIOR HIGH ATHLETICS
REGISTRATION
FOR SPORTS ACTIVITIES
Students Name:
(Last)
(First)
(Middle Initial)
Name of Parent or
Guardian
In Case of Emergency, Notify: Name,
Address,
Phone Number,
Cell Number
Registering for the following
Sport Activities:
___________________________
Grade______________________
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In order for your child to
participate in extra-curricular athletics at Central Junior High, the following
requirements must be met:
A.
Have a current
physical exam certifying physical ability to participate in the
specific
activity on
file in the school office.
B.
Purchase
hospitalization insurance provided through the school: or sign and return
the
form below
indicating that you want school insurance or you will provide your
own
hospitalization coverage.
In order for my child to
participate in extra-curricular athletics at
__________ We will purchase hospital
insurance through the school.
__________ We will
provide our own hospitalization insurance.
(Name of Insurance Company)
Before your
(son/daughter) first comes to practice. I would like to inform you that if
selected for the school team, he/ she) must maintain the following
criteria:
1.
Good attitude and
sportsmanship.
2.
Work up to his/her
scholastic level.
3.
General behavior and
citizenship above reproach.
4.
Be able to
participate in any games scheduled by the athletic department of this school and
if necessary, to travel by approved transportation to the schools not in our
district.
I hereby give permission to my
son/daughter to participate in the above listed activity. If my son/daughter is injured in the
activity, the personnel in charge will follow the procedure
listed:
1.
Attempt to call the
parent or guardian listed above.
2.
Attempt to call the
emergency number listed above.
3.
Call the local
paramedic team.
_________________________________
_________________________________
(Parents Signature)
(Date)
THIS
IF YOU HAVE
ANY QUESTIONS PLEASE CALL
Coach or Sponsor
______________________________________________________________________