2022-2023 Athletic Acknowledgement Form

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This form serves to provide verification of two important items related to the student-athlete handbook 2022-2023. Parents and athletes will complete this form together to verify receipt of the handbook (including content) and receipt of concussion guidelines, also included in the handbook.
Each participating athlete will need to complete this form or submit a printed and signed one to the Activities Director or Principal of your school:

Culpeper County High School
Activities Director: Mr. Daniel Nobbs email dnobbs@culpeperschools.org
Principal: Dr. Daniel Soderholm email ds9626@culpeperschools.org

Please enter the athlete's Last Name: *

Please enter the athlete's First Name: *

Select Grade Level of the Athlete for the 2022-2023 School Year: *

6th Grade

7th Grade

8th Grade

9th Grade

10th Grade

11th Grade

12th Grade

Please enter the athlete's student ID number: *

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