GRAND HAVEN HIGH SCHOOL ATHLETIC DEPART
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[pic] GRAND HAVEN HIGH SCHOOL ATHLETIC DEPARTMENT [pic] PARENT-ATHLETE PRE-SEASON CHECKLIST
2014-2015
[pic]
Please check the following items, then sign and date:
❑ 1. Student-athlete has a physical in the athletic office dated after April 15, 2014.
❑ 2. I understand the Academic Eligibility requirements.
❑ 3. I understand the Attendance Eligibility requirements.
❑ 4. I have read and will abide by the ‘Athletic Code’ throughout my athletic career
at Grand Haven High School.
❑ 5. I have read and will abide by the ‘Buccaneers Are Champions of Character’
Code.
❑ 6. I have read the ‘Transportation Procedure and Permission Slip’ and grant
permission for my child to ride with an approved parent/guardian of a team member.
❑ 7. I understand the Facility Fees and Insurance Fee MUST be paid prior to the first contest.
Following the first 2 weeks of practice, refunds will NOT be allowed for any athlete who
is injured, quits, or is suspended from the team. Financial Aid is available through the Athletic
Office.
❑ 8. I understand and agree to abide by the Team Rules established by the coaching staff of this
program.
Print Student’s Name___________________________________________ Sport____________________
Address______________________________________________ Date of Birth______________________
Student-Athlete Signature___________________________________________________ Date____________
* My signature confirms I have read and understand the policies checked above.
Parent-Guardian Signature__________________________________________________ Date____________
* My signature confirms I have read and understand the policies checked above.
Parent Email: ______________________________________________________________
Emergency Contact Info:
Contact: 1._____________________________________________________________ph#_______________________
Contact: 2._____________________________________________________________ph#_______________________
Family Doctor:_________________________________________________________ ph#_______________________
Special Medical Info (allergies, current medications, etc.) __________________________________________________
I_______________________________________________________, an 18 year old or the parent/guardian
of______________________________________________________recognize that as a result of athletic participation, medical treatment on an emergency basis may be necessary and further recognize that school personnel may be unable to contact me for my consent for emergency medical care. I do hereby consent in advance to such emergency care, including hospital care, as may be deemed necessary under the existing circumstances and to assume the expenses of such care.
______________________________________________________________________ _____________________
Signature of Parent or Guardian or 18 year old student Date
RETURN THE FOLLOWING 3 FORMS TO THE COACH:
1. COMPLETED ATHLETIC CHECKLIST
2. COMPLETED PHYSICAL (Dated after 4-15-2014)
3. COMPLETED VOLUNTEER ASSESSMENT FORM
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