Scullen Cross Country Registration 2019

Request edit access

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please feel free ask a coach (8th graders: cathy_malone@ipsd.org, 7th graders: monica_ploger@ipsd.org) any questions about this form or anything else about Scullen Cross Country.

Email *

Let's get a great season started!

I have received practice and meet information at: https://docs.google.com/document/d/1FuURhR1SA_FiwZoPcjxbaVsWW76hgnlJ3gFG5tSajSU/edit?usp=sharing

Yes, I have opened it AND MADE A COPY FOR ALL THE IMPORTANT DATES, ETC.

Clear selection

Last Name of the Athlete *

First Name of the Athlete *

Grade *

7th Grade

8th Grade

Gender *

Female

Male

Parent/Guardian Name *

Parent/Guardian Email *

Parent/Guardian Phone Number *

Address *

Street address, City, Zip

Is a current physical exam on file with the school nurse? *

All students trying out/practicing for a sport must have a current physical exam on file with the school nurse. A current physical exam is one that has been completed within TWELVE months of the last day of the season. Physicals are valid for one calendar year.

Yes

Not yet, but we are working on it.

Medical concerns to be shared with the coaches. *

If your child has an inhaler, they are required to have it with them in the gym at all times.

Is your student covered under a school insurance policy? *

Yes

If not, your digital signature constitutes a waiver and a confirmation of other insurance coverage. Either home or school medical insurance is required.: *

Please include the insurance company and the policy number:

Emergency Contact Name *

Emergency Contact Phone Number *

All students will be required to maintain passing grades in order to participate. *

*Three strike rule: 1st strike is a warning, 2nd strike is no games, 3rd strike is no games and no practice until grades are passing in all courses.

I understand the academic requirements.

I understand that I am responsible for transportation home from school at exactly 4:30 P.M. *

Yes, I understand.

I understand that information will be provided as the season progresses through the Google Classroom for Scullen Cross Country at classroom.google.com using code 998lys . *

We joined!

Athletes are responsible for equipment issued to them. All equipment/uniforms not returned at the end of the season will be billed to the family. *

Yes, I agree.

Have you read and agree to the terms within the district concussion form agreement? *

The concussion form can be found on the athletics page by going to this site: http://scullen.ipsd.org/uploads/Concussion%20Sign-Off%20Form%20-%20IESA%202011-2012.pdf

Yes, I agree.

Athletes are asked to pay a $125.00 fee per sport ($250.00 for two or more). Please send a check payable to Scullen with your phone number and the student's ID# prior to our first meet (August 29th). *

I am paying the $125 fee for cross country online at PushCoin.com (the same place I can pay for school lunch).

I will send a check to practice and include the student ID# and my phone number on the check.

Other:

Digital Signature of Parent/Guardian - Please type in the first and last name of the parent/guardian that is filling out this form. This constitutes written permission to participate in the Middle School Athletic Program and understanding of the inherit risk involved. *

"While participation in athletics provides student athletes with valuable and constructive experiences of both a social and physical nature, it must be remembered and understood normal participation in games and practices may also bring the possibility of serious injury. While every precaution is taken to safeguard athletes from injury, a certain amount of risk is inherent in athletic participation."

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Indian Prairie School District. Report Abuse

Forms