Clone of Chaboya After School Sports Registration

Dear Parents/Guardians,

For any student to participate in the Chaboya Middle School After School Sports Program, the information requested below is essential. Since the possibility of injury is present in even the mildest of athletic events, some form of accident or health insurance is required before any student will be allowed to participate in any sport. There is a space provided below for you to indicate the type of insurance you carry. There is also insurance coverage available by an outside carrier made available through the school district. Your son or daughter may not participate in our After School Sports Program without insurance coverage.

Student Eligibility

Student eligibility will be determined at the regular reporting periods: either quarterly report cards or progress reports. A GPA of 2.0 and no “F” grade is the minimum requirement. At the beginning of each sport, all student athletes are considered on “probation” until the regular quarterly report card or progress report, which comes out during their respective season, is issued. The date this official report is distributed at school is the “cut date”. Students who do not meet the minimum requirement are not eligible to participate in practices or events. They are dropped from the team roster. A student who becomes ineligible for one sport may try out for a future sport. The same eligibility requirements will apply.

If you have questions about the Chaboya After School Sports program, please contact our Athletic Director, Mrs. Kelly Hodgin.

Student First Name *

Student Last Name *

Grade*

Sport Registering For: *

Parent #1 First Name*

Parent #1 Last Name*

Parent #1 Email*

Parent #1 Mobile Number*

Parent/Guardian #2 First Name

Parent/Guardian #2 Last Name

Parent/Guardian #2 Email

Parent #2 Mobile Number

YesNo

Signature

Medical Condition - Please briefly describe your child's medical condition. If they do not have a condition, please state None. *

YesNo

Family insurance carrier name: *

Subscriber's name on insurance card *

Insurance Card Group Number *

YesNo

Please provide two emergency contacts in case we are unable to reach you:

Emergency Contact #1*

First NameLast Name

Emergency Phone Number*

Emergency Contact #2*

First NameLast Name

Emergency Phone Number*

Throughout the season there may be changes in practice times and game scheudules. The best way for us to text or email you is through the information you have listed in your Powerschool account. Please make sure all your contact information is correct in Powerschool so you can receive last minute notifications.

Yes

I have read, understand and will adhere to the school's social media policy.

YesNo

Student Athlete Information

Parent Contact Information & Permission

Medical and Insurance Information

Emergency Information

Communication

Transportation