Please provide the first and last name of one parent/guardian of the student athlete.

Please provide an email address for the parent/ guardian listed in the previous question.

Please provide the full name of an emergency contact person, OTHER THAN THE PARENT/GUARDIAN, that we may call in the event of an injury or illness.

Please provide a valid phone number for the emergency contact person named above.

Please enter the name of an additional person who can be contacted in an emergency.

Please provide a valid phone number for the additional emergency contact person named above.

Please indicate the sport the student intends to participate in during the Fall Season

Please indicate the sport the student intends to participate in during the Winter Season

Please indicate the sport the student intends to participate in during the Spring Season

Incoming freshman do not need to answer this question.

Please list any previous injuries, allergies, etc that may affect the student's performance

I hereby give my consent for my son/daughter to engage in interscholastic athletics and to accompany the team to away contests in all MHSAA approved sports during the current school year. My consent for my daughter/son to engage in interscholastic athletics is given with my complete knowledge and understanding that the possibility of serious personal injuries associated with participation exists. I accept full responsibility for any injuries which might occur to my son/daughter by reason of participation including, but not limited to, medical bills which may arise in excess of any insurance coverage. In addition, I give my permission and consent to have an athletic trainer (made available to Summit Academy Schools and an entity providing athletic trainer services) to provide services to my son/daughter for sports related injuries. I further agree to authorize the release of my son/daughter's health information (derived from and in connection with treatment between and among the athletic trainers between and among athletic trainers and Summit Academy athletic department). I acknowledge the Board of Education for Summit Academy and Summit Academy North Schools or any person associated with the Summit Academy athletic department are not liable under the law and will not assume any responsibility of liability relative to doctor, ambulance, or medical expense. I give my permission for immediate medical attention by a physician when in attendance at the athletic contest. My child does not have any known physical defect, disease, or condition which might prevent him/her from athletic participation. I realize my child will be held responsible for all athletic equipment issued. Further, I will help the coach carry out his/her program by seeing that my child adheres to all training rules and regulations. I understand by entering my name on the line below that this constitutes my legal signature for this document.

By entering my name on the line below, I certify that I have read the Summit Academy Schools Athletic Handbook (http://bit.ly/33xHk0x) and understand I will be expected to abide by its policies and expectations.

By entering my name on the line below, I certify that I have read the Summit Academy Schools Athletic Handbook (http://bit.ly/33xHk0x) and understand I will be expected to abide by its policies and expectations.

What is the NCAA Eligibility Center? Why is it Important? The Eligibility Center certifies the academic and amateur credentials of all students who want to play sports at an NCAA Division I or II institution as freshmen. In order to practice, play and receive an athletics scholarship, students need to meet certain academic benchmarks. An additional certification process exists to make sure the student is still an amateur, which is necessary in order for the student to compete. Students must register at (https://web3.ncaa.org/ecwr3/). Path to the Student-Athlete Experience: If student athletes wish to participate in NCAA Division I or II athletics, they need to be certified by the NCAA Eligibility Center. Students need to qualify academically and will also need to be cleared as an amateur student-athlete. Students are responsible for achieving and protecting their eligibility status! Check with your high school counselor to make sure you are on track to graduate on time with your class and have the required amount of core courses. Ask your high school counselor to submit your final transcript with proof of graduation. NCAA Guide: (http://bit.ly/2KQ5Ml4).

By entering my name on the line below, I certify that I have read the NCAA Eligibility information and understand that it is my responsibility to ensure that I have the proper credentials to participate in NCAA athletics.

By entering my name on the line below, I certify that I have read the NCAA Eligibility information and understand that it is my responsibility to ensure that my child has the proper credentials to participate in NCAA athletics.

I understand that my son/daughter must have a sports physical performed after April 15, 2019 and that the MHSAA physical form must be turned in to the athletic department before he/she will be allowed to tryout or practice with any team at Summit Academy or Summit Academy North (http://bit.ly/303oJqY). I understand my name on the line below constitutes my legal signature for this document.