Fillable Previous Athletic Participation Form printable pdf download

Page 1

Previous athletic Participation form

Revised 07/03/13

university interscholastic league

eligibility Questionnaire for new student athletes in Grades 9-12

For UIL Use Only

This form must be on file with school before Participation at any level in Grade 9-12

(To be filled out by the student and/or parent and filed with the school.)

Name of Student (print) ________________________________________________________ Grade _______ Birthdate ___________ Age ______

Student’s Current Address ____________________________________________________________________________

Current School _______________________________________ City __________________

Public/Charter School

Private School

Last School of Participation _____________________________ City __________________ State _______

Public/Charter School

Private School

Date of enrollment in current school: ________________________

Date of withdrawal from previous school: _________________________

Yes

1. has the student ever practiced or participated in extracurricular athletic activities (before school, after school or during an athletic period) at

another school in the united states or mexico in grades 8-12? if yes, the student must complete page 2 in addition to page 1 and both pages

must be sent to the district executive committee chairperson. If no, the student must complete page 1 and file with the school and/or athletic

department only.

2. Has the student ever enrolled or participated in a Magnet program, Charter school, Open/Choice Enrollment (within the ISD) or

International Baccaluarte (IB) program in grades 9-12?

if yes, please provide the name of the school ____________________________ and school year ________________.

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uestions in this section are referring to biological Parents

3. Does the parent(s) of the student reside outside the attendance zone of the school the student wishes to represent?

if yes,

a uil Parent residence

waiver may be required. contact the uil athletics department at (512) 471-5883.

married- living apart

4. Are the parents of the student

married

never married

divorced

deceased?

If the parents are married-liVinG aParT or married and the student is liVinG wiTh one ParenT,

a uil Parent residence

waiver may be required. contact the uil athletics department at (512) 471-5883.

5. Does the student live with

one parent

both parents

guardian

foster

parent(s)?

If the student lives with a Guardian or fosTer ParenT(s).

if yes, a

uil Parent residence waiver may be required. contact the uil

athletics department at (512) 471-5883.

Is there a change in schools but no change in address?

if yes, please attach an explanation.

7. Is more than one residence owned, rented or maintained by the parents?

if yes, please attach an explanation.

if yes, it should be investigated prior to partictipation on the

8. Are any members of the family still residing at the previous residence?

varsity level.

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9. Is the student enrolled in less than an average of four hours per day of instruction for either state or local high school credit?

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10.Will (or was) the student 19 years of age on or before September 1 of the current school year?

11. Did the student first enroll in the 9th grade more than 4 years ago? What was the first date of enrollment in 9th grade? _______

if yes, please attach an explanation.

12. Has the student ever repeated a grade since first entering the 7th grade?

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13. Is the student a foreign exchange student?

if yes, a foreign exchange waiver is required for Varsity athletic participation.

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14. Has the student done anything to jeopardize their amateur athletic status?

ssist in

etermining if student changed schools for athletic

urPoses

15. Has this move forced either of the parents to commute further to their place of employment?

16. Did anyone from the new school contact the student prior to their enrollment in the new school.

17. Was the student ever prohibited from participation at the previous school?

if yes, please attach an explanation.

18. Are there other family members in grades K-12 attending a different school district other than the school district the student is now

attending?

To be comPleTed by sTudenT, ParenT and adminisTraTor of new school

It shall be the responsibility of each school to have on file the following required annual forms for each student who participates in any practice (before school, after

school or during an athletic period), scrimmage or game: Preparticipation Physical Examination (for students in their first and third year of high school participa-

tion), Medical History Form, Illegal Steroid Use and Random Steroid Testing, Parent and Student Notification/Agreement Form, Acknowledgement of Rules Form,

Concussion Acknowledgement Form and Sudden Cardiac Arrest Awareness Form. Incorrect or untrue information provided by the parent or student could cause

ineligibility and could result in the forfeiture of contests in which the student has particpated in addition to other penalties. The following signatures certify that to

the best of your knowledge, all information presented on this form is true and correct.

Signature of Student

Date

Signature of Parent/Guardian

Date

Signature of New School Coach

Date

Signature of New School Administrator

Date

new school coach name

contact email address

sport