Athletics and Activities Code of Conduct Signature Packet Form

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In order to participate in Stafford County Public Schools Athletics and Activities, a form must be completed by the student and their parent/guardian. Only one form submission is necessary per student. Students who make the team will not be allowed to participate in competition until this form has been submitted. The Virginia High School League (VHSL) Athletic Participation/Parental Consent/Physical Examination form, located in the Athletic and Activities Code of Conduct (https://bit.ly/3uJ9Bk3) and also available online, is due prior to tryouts.

Attached are links to documents to the Stafford County Public Schools' Signature Packet:
Athletics and Activities Code of Conduct Student Statement of Understanding https://bit.ly/3MFZZg4
Athletics and Activities Code of Conduct Parent/Guardian Statement of Understanding https://bit.ly/3NPxw8O
Concussion Management Statement of Understanding https://bit.ly/3O0bGiU
Statement of Participation in Outside of School Athletics and Concussion/Brain Injury History https://bit.ly/3HqzmuE
Heat and Hydration Statement of Understanding https://bit.ly/3n0V52Z
Sudden Cardiac Arrest Statement of Understanding https://bit.ly/3mJdsJj

These documents can also be found on the Stafford County Public Schools website. Please take the time to review these documents, specifically the pages listed on the Code of Conduct Statement of Understanding page requiring your signature/submission.

Email *

Student Name *

Select Fall Sport *

Select Winter Sport *

Select Spring Sport *

Home Address *

Best Phone Number (Home or Cell) *

Student Date of Birth *

YYYY

Parent/Guardian Name *

Emergency Contact and Phone Number *

Family Physician *

Physician Phone Number *

Allergies/Medical Conditions *

Medications *

Parent/Guardian Authorization: If I cannot be reached in an emergency, I hereby consent for a qualified physician or surgeon to examine, diagnose, and to prescribe or perform treatment, including surgery that is deemed advisable for the welfare of the above-named participant. *

I agree

Required

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