WILDCAT YOUTH SOFTBALL PROGRAM 2009
GOOD CONDUCT POLICY AGREEMENT FOR STUDENTS & PARENT(S)/GUARDIAN(S)
I _________________________ understand and agree to abide by the rules and regulations set forth in the WCV Good Conduct Policy. If I violate any of these rules/regulations, I am fully aware of and understand that disciplinary actions may be invoked. As Parent(s)/Guardian(s) we understand what is expected of our child when participating in extracurricular activities and that disciplinary actions may be invoked for any violation.
Signed ___________________________ Date ______________
Parent or Guardian
Signed ___________________________ Date ______________
Student Athlete
Medical Information
Student Name: _________________________ Age: ______ Grade: ______
Parents/Guardians Name: __________________________
Address: _______________________________ City:__________________ State:_____
Phone: ( )-____-_____ Cell Phone: ( )-____-_____
In case of emergency, please contact the following
Name: __________________________ Phone: ( )____-_____
Name: __________________________ Phone: ( )____-_____
Please list the doctor and hospital that you designate for an emergency situation
Doctor: ____________________________ Phone: ( )____-_____
Hospital: ___________________________ Phone: ( )____-_____
Provide company name and policy number of insurance carrier
Name: _________________________________ Policy #: _________________
I/We ___________________________ understand that there are risks participating in sports. I/We agree not to hold coaches, assistants, officials, or players responsible for injuries incurred by our child. I/We give permission to our child listed above to participate in softball during the 2009 season. In case of injury or sickness, I/We assume full responsibility for all medical bills.
Signed ________________________________ Date ________________
Parent/Guardian