Western Albemarle High School

WESTERN ALBEMARLE HIGH SCHOOL

ATHLETIC DEPARTMENT

2014-2015 SCHOOL YEAR SIGNATURE SHEET

Please Read Carefully

1. All Documents are available on the WAHS sports website under “Files and Links” http://westernalbemarlesports.org/

2. Please contact the WAHS Athletic Office at 823.8705 or to receive a hard copy of all rules and regulations listed below.

3. By signing this form you are confirming that you have received, read and agree to the rules and regulations in the documents listed below for playing sports at Western Albemarle High School for the 2014-2015 school year.

I have received and read the Athletes Code of Conduct.

I have received and read the Parents Code of Conduct.

I have received and read the Student Athlete Handbook. I agree and will abide by the rules and regulations in the Western Albemarle School Student Handbook.

I have received and read the ACPS Extracurricular Code of Conduct. I agree and will abide by the rules and regulations.

I have received and read the Concussion Information for Parents and Athletes.

I have received and read the Website Permission and Authorization form and approve the posting of photos of my son/daughter along with his/her full name on the WAHS Athletics website.

$75 ACPS Athletics Participation Fee (DUE PRIOR TO TRYOUTS): See back page. Please notify the Athletic Department in confidence if you qualified for free/reduced lunch in 2013-2014. If so, the $75.00 participation fee will be waived.

Medical Insurance: Albemarle County does not provide medical insurance for athletes, including ambulance services. Albemarle County highly recommends obtaining medical insurance if an athlete is not on a family policy. Affordable policies for students are available at http://markel.sevencorners.com/ or call 877.444.5014.

Parent Signature______

Student Athlete Signature ______

Student Athlete Name (print) ______

Grade ______Sport Participating in ______

This form will need to be signed for each athletic season.