Fillable Medical and Code of Conduct Form

Please complete the following form to be submitted to Elgin Park Athletics. If you do not wish to complete the form online, a printable version of the Medical Form and Athlete Code of Conduct Form can be found under the "Forms" tab in the menu bar.

Athlete Medical Information & Code of Conduct Acknowledgement

* Indicates required field

Students Name *

First

Last

Grade *

Birthdate (DD/MM/YYYY) *

Care Card Personal Health # *

Athlete Medical Information & Code of Conduct Acknowledgement

Name of Parent/Guardian *

Home Number *

Cell Number *

Business Number *

Emergency contact other than parents

Name *

Phone Number *

Medical Concers/Allergies & Treatment *

I, the parent/guardian of the above named student, have submitted accurate information and give permission to my child to participate in Elgin Park's Athletic Program *

Agree

Acknowledgement of code of Conduct

By checking the box below, you acknowledge that both the athlete and their parent/guardian have read and agree to the Student-Athlete Code of Conduct (click below to read) *

We agree to the Student-Athlete Code of Conduct

Please indicate which sport student is participating in *

Submit

Student-athlete Code of conduct