NAME: _____________________________________ TEACHER: ____________________________

GRADE: __________ HOME PHONE: __________________________ EMAIL: _________________

PARENT/GUARDIAN: _____________________________________________

PLEASE CHECK SEASON:

TEAM HANDBALL _______ FLOOR HOCKEY __________ KICKBALL ________

I give ________________________ permission to participate in the Woodside intramural sport selected above. I understand that it is my responsibility to transport my child to school for practice / games on monday, thursday, and friday mornings at 8:00 AM (not before 7:50 please). It is also understood that my child will be supervised in the program by Mr. Pulsifer and possibly other volunteers during games and practices.

Students will get a schedule and a code of conduct sheet the first or second day of the program. Students need to have appropriate clothing and footwear to participate in intramurals. In handball and floor hockey students need to wear a mouthguard as well. In the event there is no school, intramurals will be cancelled.

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Parent/Guardian Signature ----------------------------------------Date