Sacred Heart Athletics Registration Form

Sacred Heart Athletics Registration Form



Athlete’s Name: ______

Grade (fall of 2016): ______Gender: M F

Shirt Size (circle one): Youth Large/ Adult Small /Adult Medium /Adult Large/Adult XL

Parent’s Name: ______

Home Phone: ______Cell Phone: ______

Email Address: ______

Date of Last Physical: ______

** ALL Sacred Heart students participating in athletics are required to have a sports physical form on file in order to participate. The physical must be within the last 12 months. Please turn in physical forms to the athletic director or school nurse. **


____ Volleyball (6th-8th graders) - $40 fee

____ Basketball (6th - 8th graders) - $40 fee

____ Track (5th - 8th graders) - $50 fee

____ Cheerleading (7th & 8th graders only) - $40 fee

FEES: To be paid at time of registration. Please make checks payable to “Sacred Heart Athletics.” Contact Deb Schneider for financial assistance.

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Insurance Information and Waiver

I hereby authorize any medical treatment necessary for (player’s full name) ______in event of accident/injury during Sacred Heart/parochial league practices, games or tournaments for the 2016-2017 school year. I understand that if a serious injury occurs, medical and/or hospital care will be given. Sacred Heart Parish is not responsible in case of accidental injury. I further understand that in case of serious injury, we will be notified. But if it is impossible to contact us, we grant permission for emergency treatment or surgery as recommended by the attending physician. I further understand that I am responsible for payment of any doctor and/or hospital fees arising from the treatment of my child. To assist the doctor and/or hospital in those tasks, we provide the following information:

Insurance company______

Address of insurance company______

Policy Number______

Hospital of choice______

Policy Holder name______

Authorized Signature______

Phone number______


Athletic Indemnity Agreement

I consent to (child’s name) ______’s participation in the sport(s) of ______. As a parent or legal guardian, I agree to fully release, discharge, indemnify and hold harmless Sacred Heart parish and school, its legal representatives, employees, and volunteers (all of whom shall be collectively referred to hereinafter as Sacred Heart) against any claim of cause of action whatsoever brought by or on behalf of my child against Sacred Heart which arose out of my child’s participation in the above referenced sport, regardless of whether such claim results from the negligence of individuals or companies not a party to this agreement.

I certify that I have read and understand this agreement and the risks and hazards associated with the above referenced sport(s).

Parent’s Signature______Date______

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Sacred Heart Parish Athletics

Code of Conduct


  1. All student athletes are expected to carry themselves in a mature, Catholic manner on and off the playing field. Participating in athletics is a privilege, not a right.
  1. Students should come to practice on time, ready to play, and with a positive attitude. Students are expected to give their full effort at all times and push themselves to improve with each practice. The point of practice is not only individual development but also team development.
  1. If a student will miss a practice or an event, the student is responsible for contacting one of the coaches the night before via email or phone call, or a phone call the day of the event. Teams may have very few extra players so it’s important to know as soon as possible if substitutes will be needed.

4.Students should show respect to their teammates, coaches, opposing teams and referees at all times. Students should not be talking when coaches are talking and should never talk back to a referee. Coaches are in charge of practices and students should respect all instructions and direction they provide.

5. Cell phones or any other electronic devices may be brought to practice, but must be kept in gym

bags during practice. Students are not allowed to use cell phones during practice without permission from a coach. Following practice, phones may be used to contact parents, etc.

  1. Student athletes are here to improve their skills, work on becoming a team and enjoy their athletic experience. For some students, this may be the only team activity they participate in. For others, they may be on other competitive, non-parochial teams in addition to this parochial team. Consequently, there is no room or time for those that do not want to participate on a responsible level.

Therefore, one verbal warning will be given to a student not abiding by the code. A second warning will result in the student sitting out until he/she can demonstrate cooperation with the code. A third warning will result in a call to parents to inform them that their child may be sitting out of an upcoming event due to repeated misconduct.

If a student will be sitting out of any portion of an event, he/she is expected to be in attendance for the whole event to support the team. The coach will communicate to the student and his/her parents when the student may return to play. The coach will notify parents if the student is not eligible to participate due to conduct infractions.

  1. Students should always keep in mind that they are part of a team and are representatives of Sacred Heart School. Students’ actions before, during and after an activity are a direct reflection of the students, parents and staff of Sacred Heart Parish and School.

Athlete______Date ______

Parent______Date ______

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