AMES HIGH ATHLETIC

17-18

SPORTS REGISTRATION FORM



• Registration Form signed by parent/guardian and athlete good for current school year.

•

Physical Form signed by doctor and parent. Physicals are good for 13 months.

All registrations must be complete before the first day of practice of each season.

*PRINT ALL INFORMATION*



*PRINT ALL INFORMATION*

PRESENT YEAR IN SCHOOL (CIRCLE ONE ONLY): FRESHMAN SOPHOMORE JUNIOR SENIOR Email address: Family

NAME CIRCLE ONE: MALE

FEMALE



ADDRESS HM PHONE #

AGE

PARENT(S)LEGAL GUARDIAN(S)



J U CITY N I BIRTHDATE _/ O R

ZIP CODE /

FIRST & LAST NAME(S)

CIRCLE SPORTS PARTICIPATING IN: FALL: CROSS COUNTRY



WINTER: BASKETBALL



SPRING: TRACK

FOOTBALL

BOYS SWIMMING

SOCCER

BOYS GOLF

WRESTLING

TENNIS

GIRLS SWIM & DIVE

CHEERLEADING

GIRLS GOLF

VOLLEYBALL CHEERLEADING

DRILLTEAM



SUMMER:



SOFTBALL BASEBALL



SCHOOL ATTENDED LAST YEAR (if not Ames High School) PE EXEMPTION REQUEST:

For students in grades 9,10,11: In compliance with the provisions of Chapter 12: 281-12.5(5)f of the Iowa Code, I am requesting my student receive a PE exemption for one semester during her/his athletic season. Parent’s/Guardian’s Signature

Date

For students in grades 12: In compliance with the provisions of Chapter 12: 281-12.5(5)f of the Iowa Code, I am requesting my student receive a PE exemption for (Circle your choice: ONE SEMESTER or BOTH SEMESTERS if participating in athletics both semesters) during her/his athletic season/s. Parent’s/Guardian’s Signature



Date

(OVER)

ACADEMIC ELIGIBILITY NOTE: The Iowa High School Athletic Association /Iowa Girls High School Athletic Union’s Scholarship Rule 36.15 and Ames High School’s academic eligibility requirements apply to all AHS students participating on interscholastic athletics, cheerleading and drill team. The following are the requirements of those academic eligibility rules. The student shall… 1. Have passed all classes from the previous semester or the previous two semesters if the particular period of academic ineligibility has not been served. * (Note: A withdrawal from a class after 3-weeks results in a semester grade of F.) th th th th 2. Be a full-time student. (9 and 10 grade students need 32 course contact hours per week; 11 and 12 grade students need 27 course contact hours per week.) *A full-time student is academically eligible upon entering the ninth grade.



GOOD CONDUCT POLICY Note: This policy was updated in January of 2011. It can be found in it’s entirety at our Athletic website:



ameshighathletics.org.



Athlete’s Signature

__________________________ Parent’s/Guardian’s Signature



INSURANCE This is to inform you that our child: __________________________________________is Name of Son or Daughter



Covered by a health insurance policy. Is not covered by health insurance policy. (Ames High School will not be held liable in case of an accident.)



We want to purchase the school issued accident insurance.



(Forms are available in the athletic office.)



Parent/Guardian’s Signature



HEADS UP CONCUSSION FACT SHEET IMPORTANT: Students participating in interscholastic athletics, cheerleading and dance; and their parents/guardians must sign the acknowledgement below and return it to their school. Students cannot practice or compete in those activities until this is signed.

.

This document can be read and a copy printed for your files at this site: http:/www ameshighathletics.org



“We have received the information provided on the concussion fact sheet titled, “Heads Up: Concussion in High School Sports.”





Student’s Signature

Date



Student’s Printed Name

Parent’s/Guardian’s Signature

Date



Student’s School