Parent and Student Agreement Form

As a parent of an athlete at Living Water Christian School, I agree to abide by the following agreement.

1. I have read the LWCS Athletic Handbook and agree to abide by and uphold all of the policies stated therein.

2. I give consent for my son/daughter to participate in LWCS athletic program and will hold my son/daughter to the expectations and

policies outlined in the Athletic Handbook.

3. I agree to meet all financial obligations regarding the athletic program on time unless prior arrangements with the Athletic Director have

been made. I also agree to provide all necessary documentation as required by the Athletic Department.

4. I will seek to uphold the Christian witness of the LWCS athletic program in my behavior as a parent and a spectator.

5. I agree to utilize the Matthew 18 principle in resolving conflicts.

6. I understand that my son/daughter or myself may be asked to leave the athletic program if we do not uphold the policies of LWCS athletics

as stated in the LWCS Athletic Handbook.

____________________________________ ________________

Parent Signature Date

____________________________________ ________________

Parent Signature Date

As a student participating in athletics at Living Water Christian School, I agree to abide by the expectations listed below.

1. I have read the LWCS Athletic Handbook and will abide by and uphold all of the policies stated therein.

2. I agree to uphold the Christian witness of LWCS athletics at all times.

3. I agree to utilize the Matthew 18 principle in resolving conflicts.

4. I understand that I can be dismissed from the program if I do not follow the guidelines listed in the LWCS Athletic Handbook.

____________________________________ ________________

Student Signature Date

EMERGENCY TREATMENT

To All Parents:

Since the malpractice question has come to the forefront, many hospitals and doctors will not treat a child without parent’s consent

(unless a matter of life or death). It is requested that you complete the information below so that if your child requires a visit to the

hospital while under the supervision of the school, this will allow the hospital to treat the injury.

EMERGENCY INFORMATION

Name: ______________________________ Sport: ___________________________ Sex: M _____ F _____

Grade: __________ Age: __________ Date of Birth: _____/_____/_____

Parent’s Name: __________________________________________________________________________

Father’s SS#: ________________________________ Mother’s SS#: ________________________________

Work Address: ___________________________________________________________________________

Phone Number: ____________________________

Home Address: __________________________________________________________________________

Phone Number: ____________________________

Another Person to Contact: _________________________________________________________________

Relationship: ___________________________ Phone Number: _________________________

Insurance Name: _________________________________________________________________________

Policy and Group Numbers: ______________________________________________________

ALLERGIES: ____________________________________________________________________________

Consent Statement: Authorizing Treatment

Parent’s Signature: ________________________________________________________________________

Student’s Signature (if over age 18): __________________________________________________________

I herby give my consent for _________________________________________________ to represent
(Name of Student)
______________________________________ in the sport of _______________________________.
(Name of School)	(Name of Sport)

Date: ___________________________ Signature: ____________________________________