Hill Athletic Participation Agreement

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7th Grade Girls Track & Field 2020 Season - Parents/guardians complete a form for each athlete participating in athletics at Hill Middle School. Please provide a parent email address below to receive a confirmation of completion and a copy of our athletic code of conduct, concussion waiver, and our school policies that all athletes must follow for the duration of the season.

Email *

Track & Field 2019 - 7th Grade Girls

First Name (Student Name) *

Last Name (Student Name) *

Grade *

7th Grade

8th Grade

Gender *

Male

Female

Street Address *

City/ZIP *

Parent/Guardian Name *

Parent/Guardian Cell Phone *

Optional 2nd Cell Phone

Emergency Contact *

Emergency Contact Phone *

Required Electronic Documents

Is a current physical exam on file with the school nurse? *

All students trying out/practicing for a sport must have a current physical exam on file with the school nurse. A current physical exam is one that has been completed within THIRTEEN months of the last day of the season. Physicals are valid for one calendar year.

Yes

Not Yet, but we are working on it

Medical concerns to be shared with the coaches.

If your child has an inhaler, they are required to have it with them at practice at all times

Is your student covered under a school insurance policy? *

Yes

No, See below

If not, your digital signature constitutes a waiver and a confirmation of other insurance coverage. Either home or school medical insurance is required.

Please include the insurance company and the policy number:

Hill Middle School Athletic Code of Conduct *

Parent/Guardian and athletes are asked to and read the following guidelines and submit an electronic commitment to your school, administrators, and coaches. In doing so, you are acknowledging that you have read and will comply with these guidelines and policies. Click on the link to view the athletic code of conduct: https://goo.gl/fH92n4

Yes, I have reviewed the following athletic code of conduct and I acknowledging that I have read and will comply with these guidelines and policies.

Concussion From Acknowledgment *

Click the follow link for the district concussion policy and read through the material. In doing so, you are acknowledging that you have read and will comply with these guidelines and policies. https://goo.gl/s81CRj

Yes, I have reviewed the following Concussion Sign Off Form and I acknowledging that I have read and will comply with these guidelines and policies.

Other:

Additional Statements

I understand that I am responsible for transportation home from school at BEFORE 5:00 P.M. (Practice Ends At 4:30 P.M.) *

Please note that daily practice ends at 4:30 pm each day. You should plan to pick up your child from practice at that time. (Allow 5-10 minutes for them to get changed) If transportation can not be arranged before 5:00, athletes should not attend practice that day.

Yes, I understand

I have signed up for the team text alert system, located here: remind.com/join/hill-track *

Yes

Tried to, but had technical issues

I prefer not to know when meets end or special announcements.

Other:

Athletic Fees ($125.00 per sport)

Athletes are asked to pay a $125.00 fee per sport ($250.00 per school year). Please send a check payable to Hill Middle School with your phone number and the student's ID# PRIOR to our first meet (April 4th). If payment is not made by the first meet, athletes will not be able to participate. *

I paid the $125 fee for this sport online through PushCoin (the same place I can pay for school lunch).

I paid with a check

I paid with cash

This will be the 3rd sport during the 2018-2019 school year (3rd sport is free).

I have not yet submitted this fee

Other:

Digital Signature

An email confirmation will be sent shortly after completing this form. Please read below for details.

Parent/Guardian - Please type in the first and last name of the parent/guardian that is filling out this form. This constitutes written permission to participate in the Middle School Athletic Program and understanding of the inherit risk involved. *

While participation in athletics provides student athletes with valuable and constructive experiences of both a social and physical nature, it must be remembered and understood normal participation in games and practices may also bring the possibility of serious injury. While every precaution is taken to safeguard athletes from injury, a certain amount of risk is inherent in athletic participation

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

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