RJSHS Athletic Registration 2023

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RJSHS Athletic Registration 2023 - 2024

Prior to participating in an organized team activity, please complete this registration for your student. In order to participate all athletes must:

1. Complete this registration
2. Be in good academic standing per the OSAA Handbook (a. Having earned the minimum number of credits prior to sophomore, junior and senior year. b. Having passed at least 5 classes during the previous semester.)
3. Have a valid Oregon Physical Examination (expires every two years) - Physicals are available at the Rainier
School Based Health Center. 503-556-2178
4. Payment of sports fees are required to participate at the high school level.

Please ensure accuracy with this information as the information is used for emergency purposes.

Please contact your schools Athletic Director with any questions.

High School Athletic Director: Greg Miller greg_miller@rsd.k12.or.us
Middle School Athletic Director: Shanda Wagner   shanda_wagner@rsd.k12.or.us

Email *

Student Email (@rainierk12.org account) *

Parent/Guardian Email *

Student Last Name *

Student First Name *

Parent/Guardian Last Name *

Parent/Guardian First Name *

Student Birth Date *

YYYY

Student Grade Level (2023 - 2024 School Year) *

Mailing Address *

Parent Phone Number *

Student Phone Number *

Please choose the Sports your student will participate in during Season 1 (8/15 -11/16) Fall:

HS Football

HS Girls Soccer

HS Volleyball

HS Girls Cross Country

HS Boys Cross Country

HS Cheer

MS Football

MS Boys Cross Country

MS Girls Cross Country

MS Volleyball

MS Cheer

Please choose the Sports your student will participate in during Season 2 (11/14-3/3) Winter:

HS Boys Basketball

HS Girls Basketball

HS Wrestling

HS Cheer

MS Cheer

MS Boys Basketball

MS Girls Basketball

MS Wrestling

HS Swim

Please choose the Sports your student will participate in during Season 3 (2/27-6/2) Spring:

HS Baseball

HS Softball

HS Boys Track and Field

HS Girls Track and Field

MS Boys Track and Field

MS Girls Track and Field

Please list your Insurance Provider: *

Please list your Insurance Policy Number: *

First Emergency Contact; Please list name, phone number, and relationship to student: *

Second Emergency Contact; Please list name, phone number, and relationship to student: *

Medications: *

Do you have a current and active physical? http://www.osaa.org/docs/forms/PhysicalExamination-English2017.pdf *

Yes

Do you understand the terms and conditions of the athletic code of conduct as described in the athletic handbook? *

Yes

Do you and your student consent to have your student athlete participate in random drug testing? Failure to sign will nullify the opportunity to participate in athletics. https://policy.osba.org/rainier/J/JFCIA%20D1.PDF https://policy.osba.org/rainier/J/JFCIA%20R%201%20D1.PDF https://policy.osba.org/rainier/J/JFCIA%20R%202%20D1.PDF *

Yes

Do you wish to grant permission for your student to ride home following contests with a family member over 18 or an adult over 21? If so please state those individuals (if consent is to be removed it must be stated in writing to RJSHS office). *

Parent Name: *

Student name: *

Todays Date:

YYYY

A copy of your responses will be emailed to the address you provided.

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