Interscholastic After-School Sports Permission Slip

All students wishing to participate in the after-school sports program must be enrolled in the regular school insurance plan OR submit a note signed by a parent or legal guardian stating that the student has adequate coverage. Such a note may be written on the bottom of this sheet. Students are covered for injuries incurred during scheduled practices and contests by participation in the school insurance plan.

In compliance with school policy concerning students engaged in the after-school sports program, physicals are required of all participants. Every year families provide the school with a copy of their child's physical. Physicals were also given at school in June to those students who knew they would participate in after-school sports during the 2006-2007 school year. The school nurse MUST have a copy of your child's physical before he/she can compete in interscholastic athletics.

Please fill out and sign the following permission slip and return it to school as soon as possible. If you are not enrolled in the school insurance plan, please use the bottom of the slip to indicate that you have adequate coverage. If your child wishes to participate in more than one sport during this school year, please indicate so on the form. No further permission forms will be necessary.

My child,________________________________________________
has my permission to participate in the after-school sports program at Salisbury Central School.
NOTE: This also includes permission to remain after school for all scheduled practices.

Permission is granted to participate in the following sports:
(Check those applicable.)

_____ Soccer (Boys or Girls)                           _____ Softball (Girls)

_____ Basketball (Boys or Girls)                      _____ Baseball (Boys)

Please check the appropriate insurance information.

We are enrolled in the school insurance plan. _____

We have adequate insurance separate from the school plan._____

____________________________________
Signature of parent of guardian

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Updated: September 12, 2006