Fill and Sign the Address Verification for Eligibility for High School Athletics Form

Address Verification for Eligibility for High School Athletics_______________ (Name of School) _________________________________________________________________ (street address, city, state, zip code) , Phone – _______________ FAX – _________________ Address Verification This form must be completed and returned with other required materials (physical, insurance, etc.) allowing student participation in ______________________ (Name of School) Athletics. I/we, ________________________________________________ (Name and Address) am/are the parent(s) of ________________ (Name of Student) . I/we verify that _____________________________________________ ______ (street address, city, state, zip code) , is the address where ____________________ (Full Name of Student) resides with me/us. I/we understand that my/our student athlete _______________ (Name of Student) must live with me/us within the _____________ ___________________ (Name of School) attendance area or have specific permission to attend ____________________ (Name of Student) High School in accordance with ___________________ (Name of County) County Board Policy in order to participate in any school activity. I/we also understand that the ___________________________ (Name of Athletic Association) shall not recognize guardianship or similar arrangements for purposes of eligibility. I/we understand that if it is discovered that my/our student is not eligible under this guideline that she/he may be subject to a penalty of up to and/or including one school year of ineligibility and forfeiture of games won in which she/he played. My/our signature(s) below verify/verifies that I/we have read and understand this information. I/we also understand that if I/we or if my/our child moves while enrolled, I/we will notify the school in writing and I/we will personally notify the coach. _____________________________ (Printed Name of Parent) _____________________________ (Signature of Parent) ____________________________ (Printed Name of Parent) _____________________________ (Signature of Parent)