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PHA Athletic Registration Form 23-24
22-23 PHA Athletics Registration
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* Indicates required question
Student Athlete Name
*
Your answer
Email Address
*
Your answer
Parent/Guardian Name
*
Your answer
Parent/Guardian Email Address
*
Your answer
Parent/Guardian Phone Number
*
Your answer
Date of Last Physical (Electronic or Hard Copy must be given to the nurse from within the past 13 months)
*
Your answer
Grade Level
*
6th (Only available for basketball)
7th
8th
9th
10th
11th
12th
Fall Activity Selection
Cross Country
Girls Volleyball
Girls Soccer
Boys Soccer
Clear selection
Winter Activity Selection
Boys Basketball
Girls Basketball
Cheerleading
Clear selection
Spring Activity Selection
Track
Softball
Boys Volleyball
Clear selection
My family and I understand and agree to the terms and conditions of the PHA Athletic Handbook
*
Yes
No
My family and I consent to the use of photographs/videos of my child while participating in PHA sponsored athletic events on the school's social media accounts
*
Yes
No
My Family and I have completed and understand the NFHS Concussion Course (
https://nfhslearn.com/courses/concussion-in-sports-2
)
*
Yes
No
Parent/Guardian Name For Electronic Signature
*
Your answer
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