Registration And Participation Consent Form printable pdf download

Registration and Participation Consent Form

Please complete all sections of this form for the athlete named below. Please complete one form for each

athlete in your family. In addition to this form a WIAA Physical Form or Alternate Year card is required as well

as an ImPACT test consent form. Athletes will not be allowed to participate in practice or contests until all

required paperwork is on file in the WLA office.

Student Name

Grade

2016-2017

Athletic Handbook

, including, but not limited to the Athletic Code of Contact

I have received a copy of, read, and understand the Winnebago Lutheran Academy Athletic Code of Conduct. I

agree to abide by the Code of Conduct as a WLA athlete. I also understand that the WLA code of conduct is in

effect twelve months of the year. As parent/guardian I give permission to my child to participate in athletics

offered by Winnebago Lutheran Academy. Winnebago Lutheran Academy, its staff, coaches, volunteers and

agents cannot be held liable for any injury/illness suffered as a result of these activities. As parent/guardian I

assume the liability and responsibility for any and all risk associated, both physical and financial.

Student Signature

Date

Parent Signature

Date

Wisconsin Interscholastic Athletic Association (WIAA) Eligibility Form

I have received a copy of, read, and understand the WIAA Eligibility Information Bulletin. I agree to abide by all

WIAA rules and regulations as they apply to athletic participation while I am a student at WLA. I also

understand that the WIAA rules are in effect twelve months of the year.

Student Signature

Date

Parent Signature

Date

Parent Athlete Participation and Treatment Consent

Parental or guardian consent must be granted annually for student-athlete participation. As parent or

guardian, with your signature consent to allow the student named below to engage in interscholastic athletics

sponsored by WLA during the current school year. Furthermore, permission is granted this athlete to

accompany teams he or she is a member of on out-of-town trips. It is understood that this child will also be

expected to firmly adhere to all established school and athletic policies. I hereby grant permission to

Winnebago Lutheran Academy and its representatives to seek medical attention for illness and/or injury

incurred during practice or competition. I have provided detailed and up-to-date medical information via this

student’s Power School profile.

Student Signature

Date

Parent Signature

Date

Registration And Participation Consent Form