• FULTON COUNTY SCHOOL SYSTEM DEPARTMENT OF ATHLETICS VERFICATION OF INSURANCE COVERAGE

     

    Effective for School Year 2024-2025 I have waived the medical/health insurance coverage that has been approved by the Fulton County School System and offered to my child,

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  • The medical/ health insurance that I am using for my child for the current school year at

  • is provided by 

  • the insurance policy number is

  • is in effect from:

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  • The above medical/health insurance coverage provides for the following interscholastic athletics activities:

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  • We/l understand that per The Georgia High School Association a Pre-participation Physical evaluation must be performed bya physician to medically screen each student who participates in the interscholastic athletic programs of the Fulton County School District. We/I understand that a basic medical screening (the required physical exam) is general in nature and limited in scope and does not indicate or assure me/us that my/our child is completely free from impairments. If I/we wish for a more detailed physical exam to be performed upon my/our child then it is my/our responsibility to arrange and to pay for such an exam. If this more detailed exam is performed, it is my/our responsibility to notify the Fulton County School District, and it's appropriate employees, of any potential medical problems uncovered by any physical exam given to my/our child other than the general physical required by the school system for athletic participation. I agree to fully waive any and all claims of whatever nature, fully and finally, now and forever, for my/our child, for myself. my estate, my heirs, my administrators, my executors, my assignees. my agents, my successors, and for all members of my family, and to indemnify, release, defend, exonerate. discharge and hold harmless all current. former and future members of the School Board of the Fulton County Board of Education. all current. former and future employees of the Fulton County Board of Education, their schools, their trustees, officers, Board of Education, agents, coaches, athletic trainers, physicians, volunteers, and any other practitioner of the healing arts (an "Indemnified Party") from any and all liability, personal or property damages, claims, causes of action or demands brought against the Fulton County School District or indemnified party arising out of any injuries to my/our child or to his or her property or losses of any kind which may result from or in connection with his or her participation in any activity related to the interscholastic athletic programs provided by he Fulton County School District. My signature below attests that I have read. understood and concur with the information on this form. and that I give consent for my child to participate in the athletic programs as stated above.

     

    ALL PARENTS/GUARDIANS/ MUST SIGN BELOW AND DATE

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  • PRIOR TO PARTICIPATION IN ANY CONDITIONING, TRYOUT, PRACTICE SESSION, OR PLAY IN ANY INTERSCHOLASTIC ATHLETIC ACTIVITY, THE STUDENT-ATHLETE MUST SUBMIT THIS FORM FOR PARTICIPATION IN INTERSCHOLASTIC ATHLETICS TO THE COACH OF THE ACTIVITY. FAILURE TO SUBMIT THIS FORM WILL DELAY THE ELIGIBILITY OF THE STUDENT-ATHLETE TO JOIN THE TEAM

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