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Assumption of Risk Form
Please read the Assumption of Risk document below. Then complete the questions in the survey.
We will send the completed form to your email for you to sign in the presence of a Notary Public.
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了解详情
* 表示必填
Assumption of Risk Form
Athlete's Gender
*
Gender of Athlete at Birth
Male
Female
Year of Graduation
*
Anticipated Graduation Year (2024, 2025, 2026, etc.)
您的回答
School Location
*
City or Town of School
您的回答
School Name
*
您的回答
Student First Name
*
您的回答
M.I.
*
Student Middle Initial
您的回答
Student Last Name
*
您的回答
Date of Birth
*
*Student Date of Birth
年
/
月
/
日
Mother Name
*
(First Name, Last Name)
您的回答
Mother Address
*
Full Address of Mother (Street Name, Number, Apt. No.)
您的回答
City
*
您的回答
State
*
您的回答
Zip Code
*
您的回答
Other Person
*
Name of Person, other than mother, with whom student is living?
您的回答
Student Address
*
Student Full Address (Street Name, Number, Apt. No., City, ST, ZIP)
您的回答
Contact Email Address
*
Email of Parent/Guardian
您的回答
You will receive an email with a pdf attachment of this document. This document must be notarized to be valid. If you need a Notary Public, we have one at Classical.
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此表单是在 Providence Public School District 内部创建的。
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