STUDENT ATHELETIC PARTICIPATION AGREEMENT

Name of Student:_______________________ SS#___________________

Date of Birth:_________________ Place of Birth:____________________

Name of School:___________________ School Year:_________________

Name of Sport/Activity this agreement governs:______________________

I fully understand that playing or practicing to play interscholastic sports may be hazardous and poses a risk of injury, including but not limited to, sprains, strains, contusions, abrasions, broken bones and in extreme cases, paralysis or death.

Due to the potential hazards associated with interscholastic sports, I recognize the importance of following instructions of coaches and trainers regarding playing techniques, training and other rules associated with this sport.

I understand that it is the responsibility of the parent/guardians to provide proof of medical coverage prior to a student participating in any phase of this sport.

This agreement to participate in interscholastic sports is entered into voluntarily and is made with the understanding that I have not violated any of the eligibility rules and regulations of the State Association (F.H.S.A.A.) and/or the Sarasota School District.

I acknowledge that I have read this agreement and fully understand its meaning, and that I will abide by all terms and rules associated with this sport and in this agreement.

___________________________ ________________________

Student Signature Date

___________________________ ________________________

Parent/Guardian Signature Date

___________________________ ________________________

Parent/Guardian Signature Date