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JJIAA-E1-private-school-application

Completed by Parent/Guardian PRIVATE SCHOOL STUDENT APPLICATION FOR PARTICIPATION IN\ RSU 1 CO-CURRICULAR/EXTRACURRICULAR ACTIVITIES

The parent (or student if 18 years of age or older) must submit a separate application for each activity in which participation is desired.

STUDENT INFORMATION

Student's Name: Date of Birth:

Student's Address:

Parent/Guardian's Name:

Parent/Guardian's/Student's Phone Number:

Private School Attending: Students Grade:

Private School Address:

Private School Phone Number:

Private School Principal/Head's Name:

Student is Applying for Participation in the Following Activity ­­­­­­­­­­­­­­­­­­ ­­ DOCUMENTATION CHECKLIST OF ITEMS REQUIRED FOR VERIFICATION OF ELIGIBILITY TO TRY OUT FOR PARTICIPATION: Evidence that the student currently meets the same behavioral, disciplinary, attendance and other eligibility applicable to all students in RSU 1 Student's written agreement to comply with the same behavioral, disciplinary, attendance and other eligibility applicable to all students in RSU 1

Documentation of sports physical (if applicable) and clearance to play;

Documentation of immunization presented;

Evidence of insurance;

Documentation of age eligibility; and

Documentation of academic standing (grades or other evidence that academic eligibility standards
have been met).

VERIFICATION OF ELIGIBILITY

I authorize (Name of Private School) to provide to RSU 1 upon its request all information necessary to verify that my son/daughter, meets the eligibility requirements for participation in the co-curricular/extracurricular activity that is the subject of this application.

I agree to provide to RSU 1 documentation of immunization, insurance and sports physical and clearance to play (if applicable) if such information is not maintained at (Private School Name).

Parent's Signature (or Student's, if 18 or older) Date

RSU 1 STUDENT PARTICIPATION AGREEMENT

I agree to comply with all RSU 1 policies, administrative procedures, and behavioral, disciplinary, attendance and other rules that apply to RSU 1 students participating in the co-curricular/extracurricular activity that is the subject of this application. Student's Signature Date