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James Madison High School

Extracurricular Participation Form

2006 - 2007

Please read the Extracurricular Participation Policy (and print and retain for your records and future reference), and then sign and date the statement below and return to your coach or club sponsor. Please print and submit a separate form for each activity/sport.

Student's name (print) : ______________________________________________________

Activity/Sport: _____________________________________________________________

As a student participating in Sports/Clubs at James Madison High School , I recognize my responsibility to my team/club, my school and my community. Furthermore, I recognize the potential consequences should I violate the Extracurricular Participation Policy.

Student Signature: _______________________________________ Date: _____________

As a parent/Legal Guardian of a student at James Madison High School ,


I will support and assist __________________________________'s agreement to abide by the James Madison High School 's Extracurricular Participation Policy.

Parent/Guardian
Signature: ______________________________________________ Date: _____________