Athlete's First Name Athlete's Middle Name Athlete's Last Name Athlete's Grade Level Date of Birth Street Address City Zip Code Guardian/Mom Cell Number Guardian/Dad Cell Number Athlete's Cell Number Guardian/Mom's First & Last Name Guardian/Dad's First & Last Name Parent Email Has the student attended any other high school than EHS? If yes, which High School? If yes, what year(s) attended: Emergency Contact & Relation #1: Emergency Phone #1: Emergency Contact & Relation #2: Emergency Phone #2: Allergies Other Medical Concerns: Insurance Company: Name of Insured: Policy #: Group#: Hospital Preference: Family Doctor: