2025-SJS-Athletics Registration Form FALL-Registration (Paid)-2576-NA Parent InformationParent/Guardian Full Name(Required) First Last Parent/Guardian Email Address(Required) Parent/Guardian Primary Phone #(Required)Parent/Guardian Secondary Phone #(Required)Parent/Guardian 2 Full Name First Last Parent/Guardian 2 Email Address Parent/Guardian 2 Primary Phone #Parent/Guardian 2 Secondary Phone #AgreementsArchdiocese Permission & Waiver View Archdiocese Permission & Waiver Please read this form carefully and be aware in registering your minor child/ward for participation in this program you understand and acknowledge that participation in the Athletic Program: • involves physical activities and known and unknown risks to your child. Such risks include, but are not limited to, illness, allergic reaction, property damage/loss, bruises, scrapes, cuts, bumps, fractures, concussions, paralysis, or death; and Archdiocese Waiver View Archdiocese Waiver Please read this form carefully and be aware in registering your minor child/ward for participation in this program you will be waiving and releasing all claims for injuries you and your minor child/ward might sustain arising out of this program. SJS Athletic Association Behavior and Conduct Agreement View SJS Athletic Association Behavior and Conduct Agreement It is an honor to represent St. James as a student athlete. This privilege comes with the responsibility to represent our school with the dignity that it deserves. St. James Athletics’ goal is that students play sports in a positive and safe school environment. We strive to demonstrate and instill good sportsmanship and respectful behavior. Concussion Information View Concussion Information A concussion is a type of traumatic brain injury that changes the way the brain normally works. A concussion is caused by a bump, blow, or jolt to the head or body that causes the head and brain to move quickly back and forth. Even a “ding”, “getting your bell rung”, or what seems to be a mild bump or blow to the head can be serious. Learn more at www.cdc.gov/HEADSUP/. Acknowledgement(Required) I acknowledge that I have read and discussed each of these forms with my athlete(s). This confirms our agreement to all of these forms.AthleteAthlete Name(Required) First Last Gender(Required) Male Female Date of Birth(Required) MM slash DD slash YYYY Grade (during the season of play)(Required) 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade Uniform Size(Required)Uniforms are Gildan brand.Select a sizeYouth XSYouth SYouth MYouth LYouth XLAdult XSAdult SAdult MAdult LAdult XLLast Physical(Required)Please note, the athlete you are registering must have had a physical within the last 13 months. This physical must be on file with the St. James nurses' office. Hard copies may be submitted to the main office at any time or emailed to [email protected]. ATHLETES MAY NOT PARTICIPATE UNLESS A CURRENT PHYSICAL IS ON FILE. MM slash DD slash YYYY Does Athlete have any allergies, take any medications, or have any special needs that the coaches need to know about?(Required) Yes No Allergy / Medication DetailsRegarding this child, please share any allergy/medical information (such as asthma or bee sting allergy) that is important for this child's coaches to know.FeesThis field is hidden when viewing the formSelect activity(Required) Poms ($85) Varsity Poms Girls Volleyball ($100) Cross Country ($75) Boys Basketball ($100) Girls Basketball ($100) Boys Volleyball ($50) Track and Field ($50) Soccer ($75) Activity options for girls in 4th grade: Poms ($85) Soccer ($75) Activity options for girls in 5th grade: Poms ($85) Volleyball ($100) Cross Country ($75) Soccer ($75) Activity options for girls in 6th grade: Volleyball ($100) Cross Country ($75) Soccer ($75) Varsity Poms Activity options for girls in 7th grade: Volleyball ($100) Cross Country ($75) Soccer ($75) Varsity Poms Activity options for girls in 8th grade: Volleyball ($100) Cross Country ($75) Soccer ($75) Varsity Poms Activity options for boys in 4th grade: Soccer ($75) Activity options for boys in 5th grade: Cross Country ($75) Soccer ($75) Activity options for boys in 6th grade: Cross Country ($75) Soccer ($75) Activity options for boys in 7th grade: Cross Country ($75) Soccer ($75) Activity options for boys in 8th grade: Cross Country ($75) Soccer ($75) Poms Fee Price: Volleyball Fee Price: Cross Country Fee Price: Soccer Fee Price: Basketball Fee Price: Track and Field Fee Price: Softball Fee Price: Total Parent VolunteersThere is an expectation that parents will volunteer to help out. Support your athlete by volunteering for any one or more of the following responsibilities. The director will contact you with specifics. Coach/Assistant Coach Track Meet Assistant Scoreboard Score-keeper Hall monitor Concessions Clean-up at home games Insurance InformationCurrent Insurance Company Name(Required)Current Insurance Policy Primary Subscriber(Required)Group ID #(Required)Insurance ID #(Required)PaymentPayment Method(Required)Credit Card MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name This form is completed on my own free will. My submission confirms: 1. I completed this form. 2. I authorize payment for the total amount listed. 3. I authorize medical treatment under emergency circumstances, in my absence, for the athletes I registered. 4. I acknowledge that the athlete(s) I am enrolling and I have read and agree to the Archdiocese of Chicago Permission & Waiver COVID 2021-22, Archdiocese of Chicago Waiver, SJS Athletic Association - Behavior and Conduct Agreement, and the Concussion Information.CAPTCHA
