Sports Insurance Waiver

Choose #1 or #2 and fill out.

1. My child, ______________________________, a student in the Windsor Community Unit School District No. 1, has adequate health and accident/hospitalization insurance coverage. Therefore, I choose not to participate in the insurance program offered by the WCUSD #1.

2. My child, ______________________________, a student in the Windsor Community Unit School District No. 1, chooses to participate in the insurance program offered by the WCUSD #1. I have been given the application and understand it is my responsibility to secure such insurance.

___________________________________ _____________

Signature (Parent or Guardian) Date

Sports Permission Slip

My child, __________________________ has my permission to participate in the following sport(s) for the 2006-2007 school year. (All students must have a sports physical and insurance waiver on file prior to the first practice)

Grade School Sports – No Sport Fee for 5^th – 6^th Grades
	Cheerleading (Grades 5-6)	Basketball (Grades 5-6)
Jr.High/High School Sports I understand there is a $20 sports fee per sport with a maximum of $40 per student and $50.00 per family.
	Fall Baseball	Spring Baseball
	Golf	Softball
	Cheerleading	Track
	Dance (Poms)	Volleyball
	Boys Basketball

________________________________________ ______________________

Signature (Parent or Guardian) Date