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If parents/guardian cannot be reached call:

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Emergency Contact Phone

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Relationship to Student

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Doctor Phone

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Preferred Hospital

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Any Medical Problems:

This form must be returned to the team coach along with your child's participation fee of $36.00 before any uniform will be issued and the student's participation begins. This $36.00 is to pay the CAA team entry fee.

**There will be an annual $10.00 fee in addition to the regular fee at the time that your child registers for his or her first sport each year. This fee will be used to create a uniform and equipment replacement fund. Please note : The $10.00 fee does not apply to the swim team.

If there is any question or difficulty in returning this form with the appropriate fee, please call the Athletic Director, Jack Peick at 699-1311 or 696-5414.