Athletics Alternate Year Permit

Office of Catholic Schools - Diocese of Madison

I hereby give my permission for the above named student to compete and represent his/her school in sports. I further agree to be financially responsible for the safe return of all athletic equipment issued to him/her. I also attest to the fact that the above named student has not been hospitalized or suffered any serious illness or injury since the time of his/her last physical examination. If the above has suffered any of the above or has been hospitalized for any reason since the date of his/her examination - PLEASE DO NOT SIGN THIS CARD. THIS STUDENT MUST BE RE-EXAMINED - another examination card should be obtained from the school. PARENT: If you are unsure of the seriousness of illness or injury, consult with your family doctor.

Typing your name in this box indicates your electronic signature.

ALL BOYS AND GIRLS PARTICIPATING IN INTERSCHOLASTIC ATHLETICS MUST HAVE THIS CARD ON FILE AT THEIR SCHOOL PRIOR TO PRACTICE AND/OR PARTICIPATION.

 

 

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