• Ross School Athletic Waiver

                                                        Ross School District
                                                              2021 - 2022



    Student Name                                                            Male/Female                     Grade


    Home Phone Number                                                Email Address


    Home Address                                                           Date of birth


    Parent/Guardian Name                                              Emergency Contact/Phone #

    Please check the appropriate sport(s) listed below:
    Participation Donation Fee $ - CHECK ONLY made out to Ross School

    ______       Girls Basketball (December - March) $50

    ______        Boys Basketball (December - March) $50

     Liability Waiver
    I hereby Release Ross School District, its employees, officers, agents, and volunteers of any liability in the case of injury or illness incurred while participating in the above mentioned sports activities, including transportation to and from sports activities.  In the event that I cannot be reached in an emergency, I hereby give permission for Ross School District’s representative or the assigned coach to authorize by his/her signature whatever emergency medical treatment may be considered necessary by the attending physician for my child.  I have read and understand the above statement and I understand it is a release of all claim for injuries and damages, except in the case of negligence.  My signature evidences acceptance of the provisions of the above statement. 

    Parent/Guardian Signature__________________________________________________

Last Modified on October 16, 2021