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Newtown Middle School Sports Participation Form

 

Student-Athlete’s Name________________________             Grade_______

 

I/We give permission for the above named student-athlete to participate in organized high school athletics for Newtown High School.  By signing this form below, I/we are granting our consent for the above named student-athlete to attend games and/or practices where transportation is necessary for the sport for which they have earned a spot on the team.

 

I/We acknowledge that I/We have read and understand the above.

 

 

                                                 

Parent/Guardian Signature        Date            Phone Number

 

Acknowledgement of the Sudden Cardiac Arrest Education Plan

I have read and understand the Student/Parent Sudden Cardiac Arrest Plan and Consent Form (located here) or at https://drive.google.com/file/d/0B470DYKa6aHxWVFQWnJUTmJ0Zmc/view?usp=sharing.

 

                                                

Parent/Guardian Signature                    Date                

 

                                                

Student-Athlete Signature                    Date        

 

Acknowledgement of Concussion Education for Parents and Students

I have read and understand the Concussion and Head Injury Student/Parent Awareness and Consent Form and have watched the Connecticut Concussion Task Force Video located at the following link:  http://www.connecticutconcussiontaskforce.org/CCTFtake%20twotwo.mp4

 

                                                    

Parent/Guardian Signature                        Date                

 

                                                    

Student-Athlete Signature                        Date        

 

    

 

 N.M.S. Student-Athlete Physical Form Information

 

____________________    ____________________        ______________________

(Date of Physical)        (Birth Date)                  (School Nurse Signature)

 

THIS FORM SHOULD BE SUBMITTED TO THE COACH ON THE

FIRST DAY OF TRYOUTS