Track Parent Questionnaire 2021
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Email *
Student-Athlete Last Name *
Student-Athlete First Name *
Student-Athlete Middle Initial *
Student-Athlete Gender *
Student-Athlete Grade *
Student-Athlete Birth date *
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Athlete Lives With *
Athlete's Home Address *
Have either parent/guardian or the athlete moved residences in the last 365 days? If yes please tell the old address(es) and your current address *
Athlete Cell Phone (optional)
From time to time the coaches will need to be able to communicate with the athletes. The easiest form of communication for us is the Remind App. Students can sign up for the app and then can receive and send messages from the website or their phone. This app is designed for use in schools and all communication is archived and available for review. Parents/guardians can also sign up for the app and receive all of the team messages. To sign up text the message @topsailtf to phone number 81010. We will also use students’ school email occasionally. Student-Athletes can also provide phone numbers that would only be used in case of emergency. Due to the spread out nature of track and field meets and practices, having the ability to quickly contact the athletes would be helpful. Athletes may be provided with a coach’s number and it should only be used in case of emergency. All other communication should be done in person, through the Remind App, or on school email.
Please check here if you do not want coaches to use cell phone communication with your student-athlete (again, it would only be used in case of emergency).
Parent/Guardian #1 Name *
Parent/Guardian #1 Relation to Student-Athlete *
Parent/Guardian #1 Address (If different than above) *
Parent/Guardian #1 Email (if different than above)
Parent/Guardian #1 Cell Phone *
Parent/Guardian Home Phone #1 (If none, put N/A) *
Parent/Guardian #1 Work Phone (If none, put N/A) *
Parent/Guardian # 2 Name
Parent/Guardian #2 Relation to Student-Athlete
Parent/Guardian #2 Address (If different)
Parent/Guardian #2 Email
Parent/Guardian #2 Cell Phone
Parent/Guardian #2 Work Phone (If none, put N/A)
Emergency Contact (Other than parents) *
Emergency Contact Phone Number(s) *
Please list any medical concerns we need to know about. Be sure to list any instances of food/environmental allergies, allergies to medication, asthma, seizures, diabetes, high/low blood pressure, history of fainting/passing out, concussions, heart murmur, muscular/skeletal disorders, previous injuries/surgeries, any medicines he/she is currently taking.
Insurance/Family Doctor Information (Optional)
Please tell me about your child, what do we need to know to help make him/her successful?
Anything else we need or you would like us to know
As a parent/guardian, how would you like to help the team? Please check all that apply
I affirm that all of the above information is correct to the best of my knowledge. If your child requires use of medication during/after school, a note from his/her physician must be on file in the nurse's office. I give permission for my child's medical information to be shared as needed. I give my permission for these appropriate personnel to use their medical judgement in the application of first aid treatment and in securing medical aid and ambulance as necessary. Please type your full name below as your signature of agreement to the above.
Your full name as an electronic signature *
Today's date *
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