Athletic Participation/parental Consent/physical Examination Form
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4Revised March 2013
Routing
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VIRGINIA HIGH SCHOOL LEAGUE, INC.
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1642 State Farm Blvd., Charlottesville, Va. 22911
Athletic Participation/Parental Consent/Physical Examination Form
May 1
June 30
of the current year through
Separate signed form is required for each school year
of the succeeding year.
PART I - ATHLETIC PARTICIPATION
For School Year _______
Male__________
(To be filled in and signed by the student)
Female__________
PRINT CLEARLY
Name
Student I.D #
(Last)
(First)
(Middle Initial)
Home Address
City/Zip Code
Home Address of Parents
City/Zip Code
Date of Birth
Place of Birth
This is my ______ semester in
High School, and my ______ semester since first entering the ninth grade. Last
semester I attended
School and passed______ credit subjects, and I am taking_________credit subjects
this semester. I have read the condensed individual eligibility rules of the Virginia High School League that appear below and believe I am eligible to
represent my present high school in athletics.
INDIVIDUAL ELIGIBILITY RULES
To be eligible to represent your school in any VHSL interscholastic athletic contest, you--
•
must be a regular bona fide student in good standing of the school you represent.
•
must be enrolled in the last four years of high school. (Eighth-grade students may be eligible for junior varsity.)
•
must have enrolled not later than the fifteenth day of the current semester.
•
for the first semester must be currently enrolled in not fewer than five subjects, or their equivalent, offered for credit and which may
be used for graduation and have passed five subjects, or their equivalent, offered for credit and which may be used for graduation the
immediately preceding year or the immediately preceding semester for schools that certify credits on a semester basis. (Check with
your principal for equivalent requirements).
May not repeat courses for eligibility purposes for which credit has been
previously awarded.
•
for the second semester must be currently enrolled in not fewer than five subjects, or their equivalent, offered for credit and which
may be used for graduation and have passed five subjects, or their equivalent, offered for credit and which may be used for
graduation the immediately preceding semester. (Check with your principal for equivalent requirements.)
•
must sit out all VHSL competition for 365 consecutive calendar days following a school transfer unless the transfer corresponded
with a family move. (Check with your principal for exceptions.)
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must not have reached your nineteenth birthday on or before the first day of August of the current school year.
must not, after entering the ninth grade for the first time, have been enrolled in or been eligible for enrollment in high school more
than eight consecutive semesters.
•
must have submitted to your principal before any kind of participation, including tryouts or practice as a member of any school
athletic or cheerleading team, an Athletic Participation/Parental Consent/Physical Examination Form, completely filled in and
properly signed attesting that you have been examined during this school year and found to be physically fit for athletic competition
and that your parents consent to your participation.
•
must not be in violation of VHSL Amateur, Awards, All Star or College Team Rules. (Check with your principal for clarification in
regard to cheerleading.)
Eligibility to participate in interscholastic athletics is a privilege you earn by meeting not only the above-listed minimum standards, but
also all other standards set by your League, district and school. If you have any question regarding your eligibility or are in doubt about
the effect an activity might have on your eligibility, check with your principal for interpretations and exceptions provided under
League rules. Meeting the intent and spirit of League standards will prevent you, your team, school and community from being
penalized. Additionally, I give my consent and approval for my picture and name to be printed in any high school or VHSL athletic
program, publication or video.
LOCAL SCHOOL DIVISIONS AND VHSL DISTRICTS MAY REQUIRE ADDITIONAL STANDARDS TO THOSE LISTED ABOVE.
Student Signature: ______________________________________Date: ________________________________________________
Providing false information will result in ineligibility for one year.
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