Sports Registration Form

Student’s Name
First Last
Mother’s Name
First Last
Home Phone
Work Phone
Cell Phone
Pager
Mother’s Email
Father’s Name
First Last
Home Phone
Work Phone
Cell Phone
Pager
Father’s Email
Please list any medical conditions:
Allergies (food, medicine, other):
Does your child take any medications? Please list:
The Arbor coaching staff or responsible parent has my permission to give my child acetaminophen (Tylenol), ibuprofen (Motrin, Advil) or diphenhydramine (Benadryl) in my absence.
- YES
- NO
- The Arbor coaching staff has my permission to seek emergency medical attention for my child in my absence and to make such decisions as may be required until a legal guardian can be contacted.
Print Name
First Last
Signature
Date
Date Format: MM slash DD slash YYYY

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