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Athletics
Athlete Registration 2021-22
*
Indicates required field
Student Name
*
First
Last
[object Object]
Date of Birth
*
Gender:
*
Female
Male
Grade Level for 2021-22 School Year:
*
Select one below:
5th Grade
6th Grade
7th Grade
8th Grade
School Attending:
*
Primary Parent/Guardian Email:
*
Secondary Email:
*
Note: Primary Parent/Guardian email will be the used for
ALL
Athletics communication.
My child wishes to play:
My child has previously played:
Basketball?
*
Yes
No
Basketball
*
Yes
Volleyball?
*
Yes
No
Volleyball
*
Yes
Track?
*
Yes
No
Track
*
Yes
Parent/Guardian Information:
Parent/Guardian 1 Name:
*
First
Last
[object Object]
Street Address:
*
Primary Phone Number
*
City:
*
Secondary Phone Number
*
Parent/Guardian 2 Name:
*
First
Last
[object Object]
Street Address (if different than above)
*
City:
*
Primary Phone Number
*
Secondary Phone Number
*
Emergency Contact Information
Name
*
First
Last
Relationship:
*
Other Emergency Contact Phone Number
*
Medical Information
Family Physician
*
Physician Phone Number
*
Hospital of Preference
*
Physical Examination Form:
All students participating in interscholastic athletics must have this form on file at their school/parish prior to practice or participation. A physical examination taken April 1 and thereafter is approved for the following two years of competition; physical examination taken before April 1 is valid only for the remainder of the current school year and the following year.
Choose One
*
Physical Exam Submitted Last Year
I will download, complete, and submit the Physical Examination Form.
Insurance Information
Name of Family Member Holding Insurance (Subscriber)
*
Member or Group #
*
Policy #
*
Insurance Company Name
*
Continue to Authorization for Emergency Medical Treatment
Home
Calendars
Mass Schedule
Weekly Bulletin
Update My Information
Contact Us
Grow with Us
>
Our History
About Us
>
Parish Staff
Our Parish School
Our Ministries
>
For Kids
For Teens
For Adults
>
Visitation Speaker Series
Resources
Pray with us
Mass Times
Perpetual Adoration
Sacraments
Devotions
Funerals
>
Funeral Readings
Funeral Music
St. Mary's Cemetery
Serve with Us
Parish Calendars
Human Concerns
>
Respect Life
Prayer Request
Leadership
Music Ministry
Liturgical Ministries
Thrift Shop
Christian Women
Stewardship
Support our Parish
Make a Donation
Mass Intentions
Our Parish School
About our school
>
What sets us apart
Photo gallery
Curriculum
Tours, Tuition and admissions
In the News
School Calendar
Our School Staff
For Parents
For Students
Support Our School
After School Care
Athletics