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Athletic Roster: High Schools

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ATHLETIC ROSTER: High Schools

MCPS Form 345-45A

Interscholastic High School Athletics

November 2013

MONTGOMERY COUNTY PUBLIC SCHOOLS

Rockville, Maryland 20850

INSTRUCTIONS: List in alphabetical order, the names of all team members. See the back for more specific instructions. The completed form, including signatures, must be on

file with the school athletic director prior to the first scheduled contest of the season. For team members added after start of season, complete and submit another form prior to

student participation in a contest. See the High School Athletics Handbook for additional directions.

School Number:_____________ School: ______________________________________________________________________________________

School Year Ending June __________

Activity Code:_______________ Activity: _______________________________________________________________________________________________________________________

Academic

Add

Physical

Parent

Residency

Years

Student Name

Student

ECA

School

Eligibility

NP,

Birthdate

GR Gender

Exam

Consent

Verified

at this

Number

Fee

Last Year

or M

Drop

Date

(Y or N)

School

Sport

Last

First

1st

2nd

Number of Roster Pages: __________

Total Number of Students: __________

We, coach and athletic director, certify that the information on this athletic roster is correct and that the athletes meet all eligibility requirements of MCPS, the Montgomery

County Public Secondary Schools Athletic Association, and the Maryland Public Secondary Schools Athletic Association, as appropriate.

Signature, Athletic Director__________________________________ Date_____/_____/______

Signature, Coach__________________________________ Date_____/_____/______

DISTRIBUTION: COPY 1/Interscholastic Athletics; COPY 2/School