SPARTAN BOOSTER CLUB MEMBERSHIP AGREEMENT
PLEASE PRINT LEGIBLY!
PRINT NAME OF PARENT/S: __________________________________________________________________ PARENTS EMAIL ADDRESS(ES): _______________________________________________________________ PARENTS PHONE NUMBER(S): ________________________________________________________________ EMERGENCY CONTACT PERSON:_______________________________________________________________ EMERGENCY CONTACT NUMBER:______________________________________________________________ LIST NAME AND GRADE OF EACH CHILD AT ST. JEROME IN GRADE 3 OR ABOVE: ____________________________________________________ PRINT NAME OF CHILD ____________________________________________________ PRINT NAME OF CHILD ____________________________________________________ PRINT NAME OF CHILD _____ GRADE _____ GRADE _____ GRADE
In applying for membership in the Spartan Booster Club for the 2008-09 school year, the above-listed parent/s (hereinafter the “Parent”) agrees to the following: 1. The Parent has read, understands and agrees to abide by the St. Jerome Athletic Department Policy Manual. The Parent understands that membership to the Spartan Booster Club consists of $100 (payable to St. Jerome School) and at least one valid and current email address. The $100 fee may be refunded if the Parent serves at least 6 service hours toward a Spartan Sports Event. The Parent acknowledges and agrees that if the email address is not valid or current at any time during the school year, its membership to the Spartan Booster Club may be revoked and it may be subject to the higher participatory fees. The Parent will encourage the above listed Child/ren to always do his/her best and to adhere to the Spartan Student Code of Conduct. Further, the Parent will adhere to the Spartan Adult Code of Conduct (see the reverse side). Medical Release/Parent Permission The Parent hereby permits the Child/ren to participate on the school’s athletic sports team. The Parent is not aware of any medical condition of any Child/ren that would render it inappropriate for any Child/ren to participate. Should it be necessary for the Child/ren to have medical treatment while participating, the Parent hereby gives the school personnel permission to use their judgment in obtaining medical service for the Child/ren and the Parent gives permission to the physician selected by the school personnel to render medical treatment deemed necessary and appropriate by the physician. The Parent understands that any insurance benefits that are effective have limited application.
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_______________________________________ Parent Signature
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_______________________________________ Parent Signature
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