22-23 WCUSD #15 Athletic and Activity Registration

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This registration form, along with an updated physical, must be completed prior to a student participating in our extra-curricular programs at WCUSD #15. The appropriate activity fee must be paid prior to a student competing in any contest for WCUSD #15.

Email *

Student's First Name *

Student's Last Name *

Parent's First Name *

Parent's Last Name *

Parent's Phone Number *

Parent's E-Mail Address *

Student's Grade *

Primary Junior High Fall Sport or Activity

Secondary Junior High Fall Sport or Activity

Primary High School Fall Sport or Activity

Secondary High School Fall Sport or Activity

Primary Junior High Winter Sport or Activity

Secondary Junior High Winter Sport or Activity

Primary High School Winter Sport or Activity

Secondary High School Winter Sport or Activity

Junior High Spring Sport

Primary High School Spring Sport or Activity

Secondary High School Spring Sport or Activity

We have read, understand, and had a chance to ask questions regarding the WCUSD #15 Athletic and Activity Policy. The entire extracurricular handbook can be accessed at this link: https://bit.ly/3PSKEvv *

Yes

Required

We also understand that my child must be covered by medical and/or accident insurance in order to participate in extra-curricular sports and activities and hereby certify that my child is covered for injuries and/or death occurring as a result of participation in, or the practice for, all extra-curricular events as a student in WCUSD #15 during the current school year. I also certify that said insurance will be kept in force during the full time that my child engages in the practice for or participation in extra-curricular events during the current school year. *

Yes

Required

Name of Insurance Company *

Address of Insurance Company *

Insurance Policy/Group # *

We have read and understand the information on pages twelve through fourteen of the WCUSD #15 extra-curricular handbook regrading concussions and the IHSA Performance-Enhancing Substance Policy. The entire extra-curricular handbook can be accessed at this link: https://bit.ly/3PSKEvv *

Yes

Required

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