Please fill out all information and then click submit at the bottom of the form.  

Prior to completing this form please read and/or view the following: * Code of Conduct and Athletic Eligibility Requirements * IHSA P.E.S Testing * IHSA Sports Medicine Acknowledgement & Consent * IHSA Concussion Video. These forms are linked on the EHS Athletic web page on the left hand side.
Edwardsville High School Online Athletic Registration: Athletes and parents must complete the online registration before trying out for a sport. Completion of this process does NOT guarantee the student athlete will be a member of the team. Coaches will make decisions on final rosters for each sport upon completion of tryouts.
A current physical (within 365 days) must be on file with the Athletic Director's office before an athlete will be allowed to tryout or practice.
Once the final roster is formed, an invoice for the Sports Participation fee will be sent.
*In typing in your name (Parent/Guardian & Student) in this registration, you signify that your electronic signature represents the person named and acknowledges a full understanding & acceptance of the athletic rules and agreement.
*In providing your address, you are confirming that the student-athlete and the parent(s)/court-appointed legal guardian reside full time in the attendance boundaries of Edwardsville High School.
Sport:	Field Hockey
Athlete's First Name:
Athlete's Middle Name:
Athlete's Last Name:
Grade Level:	9 10 11 12
Gender:	M F
Date of Birth (mm/dd/yyyy):
Street Address:
City:
Zip Code:
Home Phone (xxx-xxx-xxxx):
Mom/Guardian Cell Phone (xxx-xxx-xxxx):
Dad/Guardian Cell number (xxx-xxx-xxxx):
Athlete's Cell Number (xxx-xxx-xxxx):
Mother/Guardian First & Last Name:
Father/Guardian First & Last Name:
Has the student athlete attended any other high school other than Edwardsville High School?	Y N
If Yes, which high school?
If yes, year(s) attended:
Does the student reside full time with parents, custodial parent, or court appointed legal guardian?	Y N
If no, please explain:
Emergency Contact & Relation #1:
Emergency Phone #1 (xxx-xxx-xxxx):
Emegency Contact & Relation #2 (other than a parent/guardian):
Emergency Phone #2 (xxx-xxx-xxxx):
Email Address--To receive confirmation of form submission. Dist. 7 Employees must use email address OTHER than ecusd7.org.
Parent Email:
Athlete Email:
Additional Email Address:
CODE OF CONDUCT & ATHLETIC ELIGIBILITY REQUIREMENTS
I have read and I understand and agree to conduct myself in accordance with the conditions of the District 7 Code of Conduct and the IHSA Eligibility Rules. *** ALL STUDENTS WHO PARTICIPATE IN ATHLETICS AND EXTRA-CURRICULAR ACTIVITIES ARE AUTOMATICALLY SUBJECT TO THIS CODE OF CONDUCT. ***
I understand and agree to conduct myself in accordance with the conditions of the District 7 Code of Conduct and IHSA Eligibility Rules.
Student's Full Name:
I also approve of the conditions of the District 7 Code of Conduct and the IHSA Eligibility Rules.
Parent/Guardian Full Name:
PERMISSION TO PLAY AND INTENT TO FOLLOW RULES
I am aware that playing or practicing to play any sport can be dangerous involving many RISKS OF INJURY. I understand that the dangers of playing or practicing include but are not limited to death, serious neck and spinal cord injuries which may result in paralysis, brain damage, serious injury to virtually all internal organs, bones, joints, ligaments, muscles and all other elements of the skeletal/muscular system.
I recognize the dangers of practicing or playing and agree to assume the risk. I also recognize the importance of following the coaches and instruction regarding skills, safety, and team rules.
My son/daughter has my permission to play/practice in school-sponsored sports. The terms hereof shall serve as a release and assumption of risk for my heirs, estate, executor, administrator, assignees, and for all members of my family.
Student's Full Name:
Parent/Guardian Full Name:
INSURANCE WAIVER
I understand that as the parent/guardian of the above named student, I am responsible for medial expenses incurred. I certify that the above information is accurate and complete and is required for my child to participate in the sport/activity.
Parent/Guardian Full Name:
EMERGENCY MEDICAL CARE
I realize that in the case of an emergency it may be necessary to provide immediate medical care. I consent to allow my child to be treated at the nearest medical facility in the event of such emergency.
Parent/Guardian Full Name:
Physicals are only good for 1 year. Athletes must have a current physical that will be valid through the whole season. A copy of a current physical must be on file with the Athletic Director's office prior to tryouts. Student athletes will NOT be able to participate in tryouts until a copy of a current physical is on file with the Athletic Director's office. Blank physical forms can be found on the EHS Athletic web page - there is a link on the left.
Date of most Recent Physical:
Please list any health concerns, eg. allergies, asthma, etc.:
Allergies - List all:
Other Medical Concerns:
Insurance Company:
Name of Insured:
Policy #:
Group #:
Hospital Preference:
Family Doctor Name, Location, Phone #:
Parent/Guardian Full Name:
I have read and I understand the IHSA ELIGIBILITY RULES which is linked on the EHS Athletic webpage. As a condition of participation, I agree to abide by them and have signed below.
Student's Full Name:
Parent/Guardian Full Name:
I have read and I understand the IHSA CONCUSSION INFORMATION SHEET and I have watched the IHSA Concussion Video linked on the EHS Athletic webpage. As a condition of participation, I agree to abide by them and have signed below.
Student's Full Name:
Parent/Guardian Full Name:
Parent and Student Agreement/Acknowledgement Form Performance-Enhancing Substance Testing Policy
STUDENT ACKNOWLEDGEMENT AND AGREEMENT
As a prerequisite to participation in IHSA athletic activities, I agree that I will not use performance-enhancing substances as defined in the IHSA Performance-Enhancing Substance Testing Program Protocol. I have read this form and understand that I may be asked to submit to testing for the presence of performance-enhancing substances in my body, and I do hereby agree to submit to such testing and analysis by a certified laboratory. I understand that testing may occur during selected IHSA state series events or during the school day. I further understand and agree that the results of the performance-enhancing substance testing may be provided to certain individuals in my high school as specified in the IHSA Performance-Enhancing Substance Testing Program Protocol which is available on the IHSA website at www.IHSA.org. I understand and agree that the results of the performance-enhancing substance testing will be held confidential to the extent required by law. I understand that failure to provide accurate and truthful information could subject me to penalties as determined by IHSA.
Student's Full Name:
PARENT/GUARDIAN CERTIFICATION AND ACKNOWLEDGEMENT
As a prerequisite to participation by my student in IHSA athletic activities, I certify and acknowledge that I have read this form and understand that my student must refrain from performance-enhancing substance use and may be asked to submit to testing for the presence of performance-enhancing substances in his/her body. I understand that testing may occur during selected IHSA state series events or during the school day. I do hereby agree to submit my child to such testing and analysis by a certified laboratory. I further understand and agree that the results of the performance-enhancing substance testing may be provided to certain individuals in my student’s high school as specified in the IHSA Performance-Enhancing Substance Testing Program Protocol which is available on the IHSA website at www.IHSA.org. I understand and agree that the results of the performance enhancing substance testing will be held confidential to the extent required by law. I understand that failure to provide accurate and truthful information could subject my student to penalties as determined by IHSA.
Parent/Guardian Full Name:
Relationship to student: