Consent/physical Exam Form printable pdf download

2013

UPDATED APRIL

VIRGINIA BEACH MIDDLE SCHOOL LEAGUE

Athletic Participation/Parental Consent/Physical Examination Form

May 1

June 30

of the current year through

Separate examination is required for each school year

of the succeeding year.

PART I - ATHLETIC PARTICIPATION

For School

Male__________

Year____________

(To be filled in and signed by the student)

Female__________

Name

Student I.D. #

(Last)

(First)

(Middle Initial)

Home Address

City/Zip Code

Home Address of Parents

City/Zip Code

Date of Birth

Place of Birth

This is my ______ semester in

Middle School, and my ______ semester since first entering the sixth grade. Last

semester I attended

Middle School and passed______ subjects, and I am taking_________ subjects this

semester. I have read the condensed individual eligibility rules of the Virginia Beach Middle School League that appear below and believe I am eligible

to represent my present middle school in athletics.

INDIVIDUAL ELIGIBILITY RULES

Attention Athletes! To be eligible to represent your school in any interscholastic contest you:

•

must be a regular bona fide student in good standing of the school you represent

•

must have been promoted to sixth grade or must have passed five subjects in a school year preceding the present one

•

must have passed at least five subjects the previous semester and must be currently taking no less than five subjects

•

must have achieved a 2.0 grade point average in the semester preceding participation in an activity

•

must not have reached your fifteenth birthday on or before the first day of August of the current school year

•

must have been in residence at your present middle school during the entire semester immediately preceding the one in which you

desire to participate unless your transfer follows the transfer guidelines as established by the Virginia Beach Middle School

League

•

Upon transferring from another middle school, must participate at the attendance zone school in which a parent or guardian has

physical custody of you.

•

FOR ALL STUDENTS WHOSE FIRST YEAR IN MIDDLE SCHOOL WAS AFTER THE 2006-07 SCHOOL YEAR:

must not have been enrolled in middle school for a period of more than six consecutive semesters, beginning with the semester in

which he/she was enrolled for the first time in the sixth grade. The six consecutive semesters shall be counted continuously from

that point, regardless of whether or not he/she remains continuously enrolled.

•

FOR ALL STUDENTS WHOSE FIRST YEAR IN MIDDLE SCHOOL WAS PRIOR TO THE 2007-08 SCHOOL YEAR:

must not have participated in the same activity more than (3) seasons while enrolled in grades six, seven, and eight. This rule

applies to transfer students as well.

•

must not have participated in more than the allowable number of contests in the sport you wish to play (six (6) regular season

middle school contests in football or track, or eight (8) regular season middle school contests in any other sport) during the school

year, either inside or outside Virginia Beach

•

must be an amateur as defined by the Virginia Beach Middle School League: “An amateur is one who engages in athletics for the

educational, physical, mental, and social benefits one derives there from, and to whom athletics are nothing more than an

avocation.”

•

must not have received in recognition of your ability as a middle school athlete any award not presented or approved by your

school or the League

•

must not have participated in any all-star contest between teams whose players are selected from more than one middle school

•

must be in attendance at your school for at least three (3) hours on the day you wish to participate in a practice or contest

Eligibility to participate in interscholastic athletics is a privilege you earn by meeting not only the above-listed minimum standards, but also

all other standards set by your League, district and school. If you have any question regarding your eligibility or are in doubt about the

effect an activity might have on your eligibility, check with your principal for interpretations and exceptions provided under League

rules. Meeting the intent and spirit of League standards will prevent you, your team, school and community from being penalized.

INDIVIDUAL SCHOOLS MAY REQUIRE ADDITIONAL STANDARDS TO THOSE LISTED ABOVE.

Student Signature:

Date:

Consent/physical Exam Form

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