Athletic Registration

Name of Parent/Guardian Submitting Form
Student Last Name*
Students First Name*
Middle Initial*
Grade*
- 6
- 7
- 8
- 9
- 10
- 11
- 12
DOB*
MM
DD
YYYY
Gender*
- Male
- Female
Mailing Address*
Street Address City State ZIP Code

Permission to Participate
PERMISSION TO PARTICIPATE AND RELEASE Related to Board Policy 9060
I, the undersigned parent/guardian hereby grant permission for my child to participate in all athletic teams offered by North Oldham High School EXCEPT the following:*
Please type N/A if there are no athletic programs that you wish to not permit your child participate in.

Athletic Attendance Policy
Per the NOHS SBDM policy, students are required to be in attendance for three (3) full class periods in order to participate in an event (practice or competitive event) on the day of their absence. This does not include EDGE.
*
- I have read and understand the Athletic Attendance Policy.

Athletic Eligibility
According to KHSAA's Bylaw 5 and SBDM Council Requirements, to be eligible, student-athletes at NOHS must:
- have and maintain a 2.0 (or better) GPA each grading term based on a 4.0 grading scale
- be passing a minimum of 5 out of 6 classes each term (be passing all 5 credited classes if taking a non-credit class (i.e. student aide)
- maintain the proper grade level
*
- I have read and understand the Athletic Eligibility

Insurance Waiver
The Kentucky High School Athletic Associate requires that a reputable company insure each participant. You have the option of selecting the Scholastic Insurer plan offered through the school insurance program or waive the school insurance in favor of you family policy (item 2 section A or C). If you select the waiver clause, you are indicating that your insurance will be responsible for covering any medical cost or expenses that arise rather than the North Oldham High School or Oldham County Board of Education. If you select the Scholastic Insurers coverage, it will be necessary for you to purchase school insurance. You child must have school insurance or be covered by your family policy in order to participate in athletics at North Oldham High School.
Please check one of the following:
- We wish to purchase the social insurance under Scholastic Plan
- We have already purchased the Scholastic insurers school insurance
- Waive Clause

Alternative Transportion Consent
Related to Board Policy 8005 Related to 8005-AR;8005.01-F
The Oldham County Board of Education offers a broad range of sports and extracurricular activities to students enrolled in middle and high school. This broad range of activities places constraints on the ability of the district to provide transportation for all these activities at all times. As a result, there are events, practices and extra-curricular activities that will require the student's parent to arrange transportation to and/or from the event or activity. The coach or activity sponsor will provide information regarding the level of transportation provided by the district.
Name of School*
Permission Statement
*
- I give my student permission to ride the Oldham County bus to away athletic events.
The district will provide transportation to events, game and activities in accordance with 8005-AR. When the district is unable to provide transportation to events, game and activities, I consent to the following means of transportation for my child (To check more than one, press and hold shift.):*
- I give my child permission to be transported by the following adults:
List

Click the + to add addtional names.
- In consideration of the advantages to my child of participating in this sport or extracurricular activity, to the extent allowable by law I hereby release and hold harmless the Oldham County Board of Education, its members, employees, agents, representatives and insurers, and the School and its employees and agents from any liability for bodily injury or death resulting from said transportation. I sign this consent and release individually and on behalf of my student.
Student must have proof of private insurance or student accident insurance to participate in co-curricular or extra-curricular activities or field trips away from school.
- Adopted: March 16, 1981 Revised: July 17, 1983 Revised: February 22, 1993 Revised: February 10, 1998 Revised: August 15, 1998 Revised: September 1, 1998 Revised: June 23, 1999 Revised: July 14, 2000 Revised: June 26, 2006 Revised: July 16, 2008

Oldham County Board Of Education Administrative Regulation
CONSENT OF PARENT OR GUARDIAN FOR ImPACT TESTING OF HIGH SCHOOL STUDENT ATHLETES
I hereby give permission for my child to complete an ImPACT baseline test and post-concussion ImPACT tests administered at the high school for which my student is competing as needed. I understand that my child may need to complete the test more than once, depending on the results of the test. I understand the is no charge for the testing.
I further agree that the high school may release the ImPACT results and any other information related to his or her head injury to my child's primary care physician, neurologist, or other physician involved with my child's care.
*
- I give my student permission for ImPACT testing.

Parent/Guardian Preferred Phone Contact Method:*
- Home
- Work
- Cell
Phone Number
- Please contact me about North Oldham High School's digital products.
Email
Electronic Signature
I ______________________(electronic signature) have completed and agree to all of the items found in the forms of the Athletic Registration Packet.
*

North Oldham Mustangs

Athletic Registration

Athletic Registration

Step 1 of 8

Permission to Participate

Athletic Attendance Policy

Athletic Eligibility

Insurance Waiver

Alternative Transportion Consent

Permission Statement

Oldham County Board Of Education Administrative Regulation

Electronic Signature

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