Student Competition Selection

STUDENT COMPETITION SELECTION

Purpose: Use this form to register a student for school-sponsored competitions, confirm eligibility, acknowledge policies, and provide required consents. Completion and signature certify that the information provided is accurate and that the signer accepts the Selection Policies, Code of Conduct, travel and medical authorizations, and the Liability Release stated below.

Student Information

Parent / Guardian Information (if student is under 18)

Is the student under 18 years of age?     Yes

Competition Selection Details

Level (select all that apply):   School   District   State   National   International

Participation Format:   Individual   Team

Eligibility & Academic Certification

I certify that the student meets the eligibility criteria required by the competition (enrollment in the school, minimum academic standard, attendance and conduct). The school reserves the right to verify records and remove any participant for noncompliance.   I certify eligibility

Student is in good standing with respect to attendance and disciplinary matters. The following exceptions, if any, apply:

Advisor approval:   Approved by advisor (check if approved)

Emergency & Medical Information

Authorization to administer basic first aid and non-prescription medications (e.g., acetaminophen, ibuprofen) in the event of minor illness or injury:   Authorize

In the event of a medical emergency, if the parent/guardian cannot be reached, I authorize certified medical personnel to provide emergency treatment. This authorization applies only if the treatment is necessary to preserve life or prevent serious harm.   Authorize emergency treatment

Travel, Conduct & Liability Release

Travel: Participation may require travel under school supervision. Travel arrangements, itineraries, and chaperone assignments will be determined by school administration. The undersigned acknowledges that participation requires compliance with travel rules and chaperone directions.

Code of Conduct & Discipline: Students are subject to the school's code of conduct for the duration of the event and associated travel. Noncompliance may result in removal from the activity and return at the student's or parent/guardian's expense.

Liability Release and Indemnity: To the fullest extent permitted by law, I release and hold harmless the school district, its officers, employees, volunteers, and agents from all liability, claims, demands, or causes of action for personal injury, property damage, or death arising out of participation in the competition, except to the extent caused by the gross negligence or willful misconduct of the released parties. I agree to indemnify the released parties for any claims, costs, or damages asserted by third parties arising from my student's acts or omissions.

Acknowledgment of Risk: I understand and accept the risks inherent in travel and competition activities and accept responsibility for personal items and equipment.

I have read and understand the Travel, Conduct & Liability Release provisions and agree to be bound by them.   Acknowledge and accept

Media Release & Data Use

I grant permission for photographs, video, or audio recordings of the student during preparation, competition, or travel to be used by the school or sponsoring organization for educational, promotional, or archival purposes. I understand that such materials become the property of the school and may be used without further notice or compensation.

Media release:   I consent to media use     I do not consent to media use

Fees, Deadlines & Selection Acknowledgment

Fees: Entry fees, travel, lodging, and meals may be required. Fees are non-refundable unless otherwise stated in writing. Payment must be received by the date specified by the school; failure to remit timely payment may forfeit selection.

Selection is at the discretion of the school and designated coaches/advisors. The undersigned acknowledges understanding of the selection criteria, possible alternates, and appeals process as administered by the school.

Privacy, Certification & Affirmation

The information collected on this form is necessary for participation and will be used for registration, medical response, and administrative purposes. Records will be maintained in accordance with applicable law and school policy.

Certification: I certify that the information provided on this form is true and complete to the best of my knowledge. I understand that providing false information may result in disqualification from the competition and other disciplinary action.

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