Permission Slip
I
give permission for my child ___________________________ grade _______, to
participate in: Circle appropriate
sport(s)
I am fully aware that my child does not suffer from any physical or medical problems. I also understand and agree that in the event that my child should suffer from any injury of any sort while participating in the sporting activities (whether at practice or in a game), I AGREE to save and hold harmless and not to pursue any claims against Holy Spirit School and sponsoring group, any coach, or any of its agents, servants, or employees, as a result of such injury. I AGREE to ABIDE by school policy, as presented in the handbook.
Parents Signature _____________________________________________________
Printed Name ________________________________________________________
Date ___________________________
Phone:
____________________________
Return this form with a non-refundable activity fee of $50.00 for each sport. Make check payable to Holy Spirit School-HSA.
PLEASE NOTE: The activity fee covers entrance fees into the league, cheerleading competitions, and referees fees.
Medical forms that were completed for soccer are acceptable for Basketball/Cheerleading, unless the school nurse notifies you that a new one is needed.
If you have any questions, please contact me at the number below.
Looking forward to a successful season.
Basketball/Cheerleading Coordinator
Please check if you would be interested in being a team parent_____
Mary Pat Mercuro
Athletic Director