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SJCS Athletics Registration

- Programs

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- Student Name REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field.
- Sport REQUIRED Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Uniform Size REQUIRED Please fill out this field.
- Parent / Guardian Name REQUIRED Please fill out this field. Please enter valid data.
- Home Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Emergency Contact Name REQUIRED Please fill out this field. Please enter valid data.
- Relationship To Student REQUIRED Please fill out this field. Please enter valid data.
- Emergency Contact Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Disclaimer:
  I, the parent/guardian of the above-named child, hereby request that my child participate in the athletic activity listed above. I agree to direct my child to cooperate and conform with directions and instructions of the supervisory archdiocesan personnel responsible for the athletic activity.
  
  I agree that in the event my child is injured as a result of his/her participation in the listed athletic activity, including transportation to and from the activity, whether or not caused by the negligence (active or passive) of the school or archdiocesan athletic activity program or any of its agents or employees, recourse for the payment of any resulting hospital medical or related costs and expenses will first be made against any accident: hospital or medical insurance or any available benefit plan of mine or my spouse.
  
  I hereby permit the physician selected by the athletic activity supervisory personnel then present to render medical treatment deemed necessary and appropriate by the physician.
  
  I am not aware of any medical condition of my child which would render it inappropriate for him/her to participate in such activity. I will provide the school with the most recent physical exam clearing my child to participate in sports.
  
  I consent to the payment for the above sports registration will be added to my Smart Tuition account.
- I Agree Please select this field.
- Date REQUIRED Please fill out this field. Please enter a date.
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St. John Chrysostom School

Inglewood, CA

SJCS Athletics Registration