Memorial Athletics Registration
The Fall Season will start on September 12th, 2022
Sport locations
    -Soccer at Wainwright
    -Field hockey at Wainwright
    -Cross country at Memorial Middle School
    -Tennis at South Portland High School
* Transportation is provided

Each student is required to have insurance and provide a physical clearance letter from their doctor. Please fax the physical clearance letter to 767-7713 or email it to cloutisa@spsdme.org.

Please contact our athletics office if you have any additional questions at 767-7705 or email Mr. Cloutier at cloutisa@spsdme.org or Mrs. Watson at watsonja@spsdme.org

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Email *
Terms and Conditions
Parent Guardians and Student-Athletes must read and agree to following terms and conditions by clicking and reading each policy listed below to participate in the South Portland Middle School Athletics programs

Click the link below for Code of Conduct
- https://docs.google.com/document/d/18pwtmsBNng5Ur4MyTW5TIC0VQd2JPmYU1Vw-7-H6B7o/edit?usp=sharing

Click the link below for Mild traumatic Brain Injury/Concussion Annual Statement and Acknowledgement Form:
https://docs.google.com/document/d/1E1vp2B5gBGaKhhT0C0CB9qwQAN54IlEo8Z-h7bdbpsM/edit?usp=sharing

Click the link below for permission to Publish Release Form
-https://docs.google.com/document/d/1UYjVs4bgQ3b6atjpvhojTBCDroEyOrY8wxNyJDL8rrM/edit?usp=sharing



Student-athlete signature: By electronically signing below you have read and agree to all terms and conditions listed above *
Parent/Guardian signature: By electronically signing below you have read and agree to all terms and conditions listed above on behalf or your child. *
Student-Athlete Name *
Student-athlete email address *
Grade *
Primary Emergency contact/ Parent Guardian name *
Primary Emergency contact/ Parent Guardian Phone Number *
 Primary Emergency contact/ Parent Guardian Email Address *
Secondary Emergency contact/ Parent Guardian name (if none, enter N/A) *
Secondary Emergency contact/ Parent Guardian Phone Number (if none, enter N/A) *
 Secondary Emergency contact/ Parent Guardian Email Address (if none, enter N/A) *
Student-athlete Insurance Company *
Student-athlete Insurance policy number *
If you don't have medical insurance please select one of the options below
Clear selection
Most Recent Physical date *
MM
/
DD
/
YYYY
Are there any medical conditions or injuries that we need to be aware of? *
If answered yes to the question above, please explain. If none, enter N/A *
Fall 1 season sport participating in ( if none, select N/A) *
Winter 1 season sport participating in ( if none, select N/A) *
Winter 2 sport participating in (if none, select N/A) *
Spring Sport Participating in (If none, select N/A) *
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