Athletic and Club Involvement

This form should be completed and submitted to Mrs. Carlton and/or Mrs. Rhodes each time a new activity begins. One form should be submitted for each activity.

Student Name_______________________________________________________ Grade_____________

Name of activity ________________________________________________________________________

Please list all known dates of regular practices, games, and meetings (attach separate schedule if possible):

I understand the Music Attendance Policy and agree to split time 50/50 with this activity. This is considered an exception to the Athletic Attendance Policy. That policy states, “Any exception to the attendance rules must have prior approval of athletic director or principal.” I understand that it is my [the student’s] responsibility to obtain this approval and notify Mrs. Carlton and/or Mrs. Rhodes if this is not possible.

__________________________________________________ _________________________________

Student Signature Date

__________________________________________________ _________________________________

Parent/Guardian Signature Date

__________________________________________________ _________________________________

Coach/Activity Sponsor Signature(s) Date