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Sign up/Waiver Form

FLATHEAD TAC

STRENGTH AND PLYOMETRICS PROGRAM

TAC WAIVER/SIGN-UP FORM

  • Please Turn form into Activities Office or Coach Dotson

Student Acknowledgment:

I, ____________________________________________________, have read and understand

(Print full name of Student-Athlete)

the Flathead High School weight room regulations and agree to comply with them as written. I also agree to comply with all verbal and written instructions communicated by the weight room supervisor. I acknowledge that my failure to comply with these rules / instructions may result in loss of weight room privileges and / or disciplinary action from the high school administration. I am fully aware of the risks involved in any form of physical activity. I understand that even with the best instruction, proper use of equipment, and strict adherence to rules / regulations injuries are still a possibility. I agree to accept these risks as a condition of my participation in the after school / summer weight room program.

__________________________________________________ ________________

(Signature of Student-Athlete)                                                             Date

Parent / Guardian Consent:

It is with my consent that my son / daughter

________________________________________________________

(Print full name of student) participates in the summer TAC program conducted by Flathead High School. I am aware that any form of physical involves the risk of injury. I acknowledge that even with the best instruction, proper use of equipment, and strict adherence to rules / regulations injuries are still a possibility. On rare occasions, these injuries can be of a serious nature to result in varying degrees of disability or even death. I acknowledge that I have read and understand the warning stated in this document.

__________________________________________________ _________________

(Signature of parent / guardian) date

Student Information:

Home phone #____________________Cell #__________________________

Student email ___________________________________Shirt size_____________________

Student grade level (7-12) ________________ In TAC Last Summer:  (Circle)  No  /  Yes 

School attending this upcoming year: __________________________________________

Sports participated in: Fall _______________Winter_____________Spring ________________

Physical (Not Required for TAC): (Circle) No  /  Yes   :  Month_____ and Year 20__

  • Please turn in physical forms to Trainer Amy Thorson for School Athletics

Emergency contact name: _____________________________

Emergency phone number _____________________________

For Additional Information Visit:

www.sd5.k12.mt.us/fhs/

“Click” Athletics, then “Click” Strength and Conditioning

  • Please Turn form into Activities Office or Coach Dotson

 

 
 
 
Last Modified on May 19, 2014