BES INTRAMURAL SPORTS REGISTRATION FORM

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TO: Parents of Students in Grades 5 & 6

FROM: Kyrstin Bervert

DATE: October 21, 2022

Intramural sports are offered each year for 5th & 6th grade students to participate in, the fee is $25.00 per year. Our next session is volleyball. If your child is interested in the volleyball session, you will need to fill out the registration form below and submit it with $25.00 (if not already paid during a previous session) to school by Wednesday, November 2nd. (Without this registration form being submitted completely and payment made, your child will not be able to participate). The session will run from Wednesday, November 2nd through Thursday, December 1st. Practice will be held BEFORE school every Monday, Wednesday, and Thursday from 7:45pm to 8:45pm for both boys and girls. Participants should not be dropped off prior to 7:45am. ***Exception: There will not be Intramurals on Thursday, November 10th. It is rescheduled to FRIDAY, Nov. 11th

VB Tournament on December 1st from 7:45am-8:45am - Parents are welcome to attend.

Each student is responsible for his/her own transportation. Supervision for your non-participating students is not available.

The school district provides insurance for students while they are participating in school sponsored activities. It is a co-insurance with your family policy and the coverage is limited. Please read the certificate of coverage handed out at enrollment.

INTRAMURALS is designed to be a fun program for all levels of physical abilities. This session will offer volleyball activities. This program requires students to exhibit appropriate behavior during the limited one-hour activity. This will allow our coaches and students to cover more of the basic fundamentals of the sport. Students who are unwilling to follow coaches' instructions will not be allowed to continue the program.

Does your student have permission to participate in the Intramurals session of volleyball? *

YES

Child's First Name *

Child's Last Name *

Child's Gender *

Male

Female

Child's Grade *

5th

6th

Child's Teacher *

Baustista

Hayen

Helmke

Foster, M.

Scharrer

Watson

Parent First Name *

Parent Last Name *

Parent Contact Number *

Emergency Contact First Name *

Emergency Contact Last Name *

Emergency Contact Phone Number *

I understand that the program will start on Wednesday, November 2nd and run through Thursday, December 1st. Practice will be held every Monday, Wednesday, and Thursday BEFORE school, from 7:45am-8:45am, for boys and girls. ***Exception: There will not be Intramurals on Thursday, November 10th. It is rescheduled to FRIDAY, Nov. 11th *

YES

I understand that the school does not provide transportation for my child, and in order for him/her to participate it will be my responsibility to provide transportation. *

Yes

I understand that Intramurals participants should not be dropped off prior to 7:45am. *

YES

I understand that if my child is consistently being dropped off prior to 7:45am, my child may be removed from the program. *

YES

I understand the school does not provide supervision of non-participants. *

YES

I understand that the ONE TIME yearly fee of $25 for Intramurals will need to be sent to the school office, or paid over the phone via credit/debit card, prior to my child starting the program. *

YES

Parent Signature: Typing your name below stands for your signature and permission for your child to participate in the Intramurals session of volleyball. *

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