HOLY CROSS CATHOLIC SCHOOL

serving preschool - grade 8
6100 37th Street West
Webster, Minnesota 55088

952-652-6100

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Basketball Open Gym

- Student Life

*There will be a $50 charge for non Holy Cross families
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- 2023-2024 BASKETBALL OPEN GYM REGISTRATION
  
  FOR HOLY CROSS STUDENTS IN GRADES 5 - 8
- PARENT/GUARDIAN INFORMATION
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Home Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- STUDENT ATHLETE INFORMATION
- How many students are you registering? REQUIRED Please fill out this field.
  
  Student Athlete 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field. Please enter an integer (number).
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Medication my child is taking at present REQUIRED
  If none, enter "none".
  Please fill out this field. Please enter valid data.
  
  Allergies REQUIRED
  If none, enter "none".
  Please fill out this field. Please enter valid data.
  
  Other Medical Conditions REQUIRED
  If none, enter "none".
  Please fill out this field. Please enter valid data.
  
  Student Athlete 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field. Please enter an integer (number).
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Medication my child is taking at present REQUIRED
  If none, enter "none".
  Please fill out this field. Please enter valid data.
  
  Allergies REQUIRED
  If none, enter "none".
  Please fill out this field. Please enter valid data.
  
  Other Medical Conditions REQUIRED
  If none, enter "none".
  Please fill out this field. Please enter valid data.
  
  Student Athlete 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field. Please enter an integer (number).
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Medication my child is taking at present REQUIRED
  If none, enter "none".
  Please fill out this field. Please enter valid data.
  
  Allergies REQUIRED
  If none, enter "none".
  Please fill out this field. Please enter valid data.
  
  Other Medical Conditions REQUIRED
  If none, enter "none".
  Please fill out this field. Please enter valid data.
  
  Student Athlete 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field. Please enter an integer (number).
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Medication my child is taking at present REQUIRED
  If none, enter "none".
  Please fill out this field. Please enter valid data.
  
  Allergies REQUIRED
  If none, enter "none".
  Please fill out this field. Please enter valid data.
  
  Other Medical Conditions REQUIRED
  If none, enter "none".
  Please fill out this field. Please enter valid data.
- Family Health Plan carrier number REQUIRED Please fill out this field. Please enter valid data.
- Family Doctor's Name REQUIRED Please fill out this field. Please enter valid data.
- Family Doctor's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- EMERGENCY MEDICAL TREATMENT
  
  In the event of an emergency, I give permission to transport my child to a hospital for medical treatment. I wish to be advised prior to any further treatment by a doctor or hospital. In the event of any emergency, if you are unable to reach me at the above numbers, contact:
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- I grant permission for the child(ren) listed above to participate in the above named activity and I warrant that my child is in good health. In consideration of my child’s participation, I agree to indemnify Holy Cross Catholic School and the Archdiocese of Saint Paul and Minneapolis from any claims or law suits brought against the parishes/Holy Cross Catholic School /Archdiocese of Saint Paul and Minneapolis by myself, my child or others, that arises out of any behavior by my child at the event/activity described above. I also agree to pay reasonable attorney’s fees or expenses incurred by the parish/school and the Archdiocese in defense of such a claim/suit.
  
  As Parent or Guardian, I agree to all of the above stated considerations and conditions.
  
  I Agree Please select this field.
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