INDIVIDUAL INFORMATION SHEET

Track

NAME:__________________________________________________________

(as it appears on your Birth Certificate)

ADDRESS:_____________________________________________________________________

GRADE:DATE OF BIRTH: __________AGE:

Did you attend BEHS last year? Y N Date that you entered BEHS: ________________

If not where did you attend?_______________________ How long were you there:________

Address of last school attended:__________________________________________________

Fill out the following if you moved into the attendance area for this school year:

Status of former residence: Sold ___ Renting ____ Vacant____

Date of change of residence into BEHS attendance area:_____________

New address:__________________________________________________________

How many classes did you TAKE in the FALL semester?_______

How many did you pass:________ (put a number)

Father’s Name:___________________________ Home number_____________

Work/cell number_________________

*Email:_________________________________________

Mother’s Name:______________ Home number_

Work/cell number_________________

*Email:_________________________________________

Do you want warm ups? Y N size S M L XL

The cost of the warm ups is $950, please make check payable to BEHS Track

The following forms and checks must be included with this form

Physical: signed by physician. If a physical is on file from this year please indicate that on the physical form that is included. Parents must sign the physical regardless of whether one is on file or not.
Athletic Insurance Form
$5 check for Catastrophic Insurance
Uniform Policy Sheet
Cell Phone policy Sheet
Athletic Department Drugs, Alcohol, Tobacco and Misrepresentation form
Original Birth Certificate to show to Athletic Director
$30 check/cash. For team food at meets
$95 check for warm-ups. Only if you want warm-ups.

Your signature on this form indicates that you have read all of the forms provided and will comply with the attendance and lettering, transportation and drug policies of the team.

Parent’s Signature:______________________Athlete’s Signature:______________________