Previous Athletic Participation Form Page 2
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2Previous athletic Participation form
Page 2
university interscholastic league
Revised 07/03/13
All new students in grades 9-12 who have ever practiced or participated in baseball, basketball, cross country, football, golf, soccer, softball, swimming and
diving, team tennis, tennis, track and field, volleyball or wrestling in grades 8-12 at another school in the United States or Mexico MUST have this form
completed by the last school of participation and be approved by the District Executive Committee before they are eligible to participate at the VarsiTy
leVel at the new school.
A student being continuous enrolled for one calendar year still requires a Previous Athletic Participation form before they are
eligible to participate at the VarsiTy leVel
in
athletics.
Name of Student
Current School
Last School of Participation
Student’s new address:
Street
City
State/Zip Code
i.
eliGibiliTy cerTificaTion: This section should be completed by the individual(s) with whom the student is currently residing at the
new school. We, the undersigned, certify that the student is in compliance with the transfer and admission policies of the local school district. This
student is not changing schools for athletic purposes and was not recruited. We understand that any false or incorrect information could cause the
student to be declared ineligible and could result in the forfeiture of contests in which the student has participated at the new school, in addition to other
penalties.
Status of previous residence?
sold
leased
vacant
still own
Previous address
PARENT SIGNATURE
DATE
WITNESS FOR PARENT SIGNATURE
DATE
New school administrator or notary public (NOTARY SEAL)
if witness is the new school administrator, notarization is not required.
ii.
new school cerTificaTion: We certify that to our knowledge no one from our community has offered any inducement, directly
or indirectly to the student or parents to move into our district. To the best of our knowledge this student is not changing schools for athletic
purposes.
Name of New School
Signature of new school superindendent or designated administrator
Date
iii.
lasT school of ParTiciPaTion cerTificaTion and release: Section III must be completed for any new student in grades
9-12 who has ever participated in baseball, basketball, cross country, football, golf, soccer, softball, swimming and diving, team tennis, tennis,
track and field, volleyball or wrestling in grades 8-12 at another school in the United States or Mexico before they are eligible to participate at
the varsity level at the new school. Please check the appropriate responses below.
if any of the questions in this section are marked ‘yes’ a full hearing
of the district executive committee (dec) is required in the new district.
Yes
No
1. Was there any conflict or dissatisfaction between the student, his/her parents, and the athletic/academic supervisors at the school?
2. Was this student recruited to attend another school or was any undue influence exerted upon this student or family to change schools?
3. Did this student quit an athletic activity or program while enrolled in your school? if yes, attach explanation to dec.
4. Was this student ever suspended or removed from your school athletic program? if yes, attach explanation to dec.
5. Would the student be prohibited from participation in athletics had they not changed schools? if yes, attach explanation to dec.
6. Based on your knowledge of the student and their circumstances, is this student changing schools for athletic purposes?
Print Name of Former superintendent or designated administrator
Print Name of Former principal or coach
and
*Signature of Former superintendent or designated administrator
*Signature of Former principal or coach
Date Signed
(* two signatures required)
Last School of Participation _______________________________
City __________________________
State __________
iV.
eXecuTiVe commiTTee aPProVal: We certify the above named student is approved.
Check the appropriate box:
Varsity
sub-varsity only
(
applying for a waiver)
any ‘yes’ answer in section iii to questions 1-6 above requires a full hearing of the district executive committee (dec) to determine
the eligibility status of the student and required before applying for a Parent residence rule waiver. The student would be ineligible for varsity
athletic participation until the dec hears testimony from the previous school, the student/parent and the new school and makes an eligibility
determination.
daTe of hearinG _____________________________
School
Conference
District No.
(School of District Executive Committee Chairman)
Signature of District Executive Committee Chairman
Date
Contact Email Address
The District Chairman makes two copies of the completed form. Send one copy to the student’s current school and the other copy to the University Interscholastic
League, Box 8028, University Station, Austin, Texas, 78713. Retain the original in your file.
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