Parent Approval & Responsibilities Form For Athletics & Competitive Activities
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2Township High School District 211 Parent Approval and Responsibility
for Athletics and Competitive Activities
Return this form to the Activity Director's office.
Do not include with mail back registration.
Dear Parents:
The school district recommends that parents obtain adequate health, accidental, and disability insurance for their participating student.
The hazards of physical injury are inherent in athletic and activity participation, and these injuries could be severe or fatal, including but
not limited to fractures, brain injuries, and paralysis.
We believe it is important for you, as a parent of an athletic/activity participant, to know that except for very limited circumstances, neither
the school district, its Board of Education, Board members individually, nor employees are liable for injuries to students resulting from
participation in school activities, including athletics. Generally, only where it has been found that a District 211 employee or other person
acting on its behalf has been guilty of willful and wanton conduct is liability imposed. Parents must also assume full responsibility for any
practicing of their son or daughter outside of the school athletic/activity program.
Academic Eligibility
To be eligible for participation in interscholastic athletics and/or activity contests, a student must be passing four (4) academic courses on a
weekly basis and maintain a 2.0 on a quarterly basis (excluding physical education and driver education) during the period of participation
as well as the semester prior to participation, with no failing grades.
All students desiring to compete in activities/athletics must complete all of the information requested below.
Sport/Activity ______________________________________________
❏ Frosh.
❏ Soph.
❏ Jr.
❏ Sr.
I.D. Number _______________________________
Name _______________________________________________________________________
Last
First
Middle Initial
Birth Date ____________________________________________
❏ Male
❏ Female
Month
Day
Year
Parent/Guardian’s Name ________________________________________________________
Primary Telephone (_____)______________________________ Alternate Telephone (_____)_______________________________
Parent/Guardian’s Address _____________________________________________________________________________________
Street
City, State
Zip Code
Family Doctor _____________________________________________ Telephone (_____)_________________________________
Are you a transfer student? ❏ Yes
❏ No
If yes, list all high schools you have attended in the last 12 months:
School ________________________________________________ Town _________________________________ State _______
School ________________________________________________ Town _________________________________ State _______
Do you and the adults with whom you reside currently live within ❏ PHS ❏ FHS ❏ CHS ❏ SHS ❏ HEHS attendance boundaries? ❏ NO
It is with my full knowledge and consent that my son/daughter, ___________________________________, participate in interscholastic
athletic/activity competition at High School District 211 subject to the conditions stated on this form. I have read the enclosed Athletic
and Competitive Activity Policies and Procedures for District 211 and agree to help my son/daughter live up to the standards for High
School District 211.
_________________________________________________
_______________________________________________
Student-Athlete Signature
Date
Parent/Guardian Signature
Date
In addition, all FRESHMAN AND TRANSFER STUDENTS are required to complete the information requested on the reverse side of this form.
TO BE COMPLETED BY SCHOOL NURSE
Date of Physical ______________________
__________________________________________________
School Nurse Signature
Date
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