Athletic Activities Packet

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Athletic/Activities Packet
(2015)
Check off List:
_____ Parent and Student must read the “Athletic and Activities Code”.
_____ Parent and Student must read the “Concussion Information Sheet”.
_____ Complete and sign “Medical Insurance & Emergency Authorization Form”.
_____ Must have current medical physical on file. Physicals are good for 24 months from date of exam.
_____ Current ASB Card Required
_____ All forms must be returned to the Athletic Director’s office before student will be cleared for participation.
_____ Athletic Director will check your grades for academic eligibility.
NAME _________________________________________________DATE __________
GENDER___ M ___ F
BIRTHDATE_________________GRADE LEVEL______
ADDRESS ______________________________________________________________
HOME PHONE NUMBER ________________________________________________
SCHOOL ATTENDED LAST YEAR ________________________________________
th
________ Foreign Exchange Student (Must complete WIAA Form 6) __________ 5
Year Senior ________ Home School
Please check one sport per season for the current school year
Fall Sports:
Winter Sports:
Spring Sports:
_____ Team Manager
_____ Boys Tennis
_____ Boys Basketball
_____ Baseball
_____ Cross Country
_____ Boys Swim
_____ Boys Soccer
Activities:
_____ Football
_____ Girls Basketball
_____ Fastpitch
______ Band
_____ Girls Soccer
_____ Girls Bowling
______Football (Spring)
______ Cheer
_____ Girls Swim
_____ Wrestling
______Golf
______ Drill
_____Volleyball
_____Team Manager
_____ Girls Tennis
_____ Flag Team
_____ Team Manager
_____ Track
STUDENT: I am aware that playing or practicing to play/participate in any sport can be a dangerous activity involving
many risks of injury. I understand that the dangers and risks of playing or practicing to play/participate in sports may
result not only in serious injury, but in a serious impairment of my future abilities. I recognize that the danger of risk is
even greater in contact sports such as football and wrestling. Because of the dangers of participating in sports, I
recognize the importance of following coaches’ instructions regarding playing techniques, training and other team rules,
etc. and agree to obey such instructions.
I have read and understand:
_______ the risks involved in athletic participation.
_______ the BSD Athletics and Activities code and agree to abide by that Code.
_______ the Bremerton High School Concussion Information Sheet and agree to abide by those instructions.
Student Signature ___________________________________________________Date_______________________
PARENT: I have read and understand:
________ the risks involved in athletic participation.
________ the Bremerton School District Athletics and Activities Code.
________ the Bremerton High School Concussion Information Sheet.
As the parent/legal guardian of _______________________, I agree to support my student in abiding by the code.
Parent Signature ___________________________________________________Date________________________

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