2019 Bev Facey Football Registration

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Please complete the following information to register for Bev Facey Football for the 2019 season.

Student-Athlete name (First and Last): *

Grade *

Grade 10

Grade 11

Grade 12

Date of Birth *

YYYY

Student-Athlete Cell number (XXX-123-456 format) *

Parent #1 name (First and Last) *

Parent #1 primary contact number (XXX-123-456 format) *

Parent #1 secondary contact number (XXX-123-456 format)

Parent #1 primary email contact *

Parent #2 name (First and Last)

Parent #2 primary contact number (XXX-123-456 format)

Parent #2 secondary contact number (XXX-123-456 format)

Parent #2 primary email contact

Medical Information (Please check all that apply) *

Allergies

Asthma (ONLY if you are actively still using an inhaler during the day for any reason)

Concussion (Past 2 years)

Diabetic

Contact Lens

Breaks/Sprains/Dislocations (Past 2 Years)

Brace Wearer

Do you require taping prior to practice/games?

Required Medication the support staff needs to be aware of

NOT applicable

Required

If you indicated YES to any of the above, please provide further information (Details/Severity and Medication required), what are known triggers and if student-athlete can self-administer.

Elements of Risk Notice *

There is an element of risk in every athletic activity. The safety and well being of our student-athletes is a prime concern and attempts are made to manage the foreseeable risks inherent in physical activity by taking appropriate precautions. However, due to the very nature of football, the risk of injury may increase. Injuries may range from minor sprains and strains to injuries more serious in nature. *It is HIGHLY recommended that all athletes have a yearly medical done before football starts. Transportation will be provided to and from Emerald Hills Field/Clarke Park/Foote Field/Johnny Bright Park as part of camp and season where needed. All student-athletes must ride on the school provided transportation to and from the venue. I hereby authorize the team to secure such medical advice and services as may be deemed necessary for the health and safety of my son/daughter/ward. I agree to accept financial responsibility in excess of the benefits allowed by Alberta Health Care and other insurance plans. *

I acknowledge that the information I have provided is correct and give consent to the school to use the above information for the purposes described above for the 2019 football season. Further, I consent to my son/daughter//ward traveling with the team on school provided transportation

Required

Student-athletes will be required to have their medical/registration form completed, individual player and fundraising fees' submitted prior to the first league game. Cheques can be made out to Strathcona Amateur Football Alumni Association and returned to the general office. Required Player Fee ($550.00) *

I acknowledge fees are due prior to the first league game for my son/daughter/ward to remain eligible.

Required

I, as above indicated parent/guardian, authorize Bev Facey to provide the Football Parent Group access to my contact information for the purposes of team activities. *

Yes

Required

I am aware there is a compulsory parent meeting for all families of the football program on Wednesday, August 21 @6pm in the South gym. Additionally, I am aware of the team bottle drive dates of August 24 and September 28. *

Yes

Required

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