Desktop Schools Popup

Select a School

604.4.1.3.2P - Parent/Guardian Request Form: Middle School Student Participation in High School Junior Varsity or Varsity Athletic Activities-Gifted Athlete

604.4.1.3.2P - Parent/Guardian Request Form: Middle School Student Participation in High School Junior Varsity or Varsity Athletic Activities-Gifted Athlete

Adopted: July 1986
Revised: September 2025

 

Download 604.4.1.3.2P - Parent/Guardian Request Form: Middle School Student Participation in High School Junior Varsity or Varsity Athletic Activities-Gifted Athlete

NOTICE: The purpose of this form is to request that the middle school student identified below be considered for participation in an athletic activity at the high school junior varsity or varsity level. Such participation is an exception to normal practices, but is appropriate for some skilled athletes whose level of performance exceeds the competition at the middle school level and who otherwise meet the criteria for participation at the high school level.

The student’s parent/guardian and the student should review and complete this form together and return it to the student’s middle school athletic director. The information provided on this form will be used by school staff in the process of determining the student’s eligibility to participate in high school athletics. You are not required to provide the requested information, but failure to do so will prevent the school district from considering the request for the student to participate in high school athletics.

 

Student’s name

Parent/Guardian’s name

Address

Phone

Sport

Current Middle School

Attendance Area High School

High School of Athletic Participation

 

ACKNOWLEDGMENTS - Please Review and Initial the Following Acknowledgment Items

 

Acknowledgment Item

Parent/Guardian & Student Initials

1.

I have received, read and understand District 196 Regulation 604.4.1.3AR, Middle School Student Participation in High School Junior Varsity Athletic Activities – Gifted Athletes.

 

2.

I am aware that a current physical must be on file with the school district in order to participate in high school athletics.

 

3.

I understand that approval to participate in high school athletics depends on meeting academic, attendance and behavioral standards.

 

4.

I understand that failure to continue to meet academic, attendance and behavioral standards may result in restricted or revoked approval for participation in high school athletic activities.

 

5.

I understand that in order to participate, I must first be selected for a high school junior varsity or varsity team.

 

6.

I have notified the high school coach of the team for which I wish to try out.

 

7.

I understand that school or team schedules will not be adjusted to accommodate a middle school athlete’s schedule.

 

8.

I understand that student-athletes will only receive excused absences for games or matches, not practices.

 

9.

I understand that I am responsible for arranging the student’s transportation to practices, games and matches.

 

10.

I am aware that students planning to attend a high school outside of their attendance area are subject to District Procedure 502.2P, Attendance Priorities for Transfer Students OR District Procedure 502.4.1AR, Student Transfers: State Enrollment Options Program. Gifted athlete approval does NOT guarantee acceptance or provide preference in the transfer process to a school outside of my attendance area.

 

 

PARENT STATEMENT:

Briefly describe your child’s past experience and participation in the sport:

 

 

 

STUDENT STATEMENT:

I feel my skills will allow me to be successful on the high school team because:

 

 

SIGNATURES:

__________________________________________________                                                                                                    

Parent or guardian signature                                                                      Date

__________________________________________________                                                                                                    

Student signature                                                                                            Date

 

 

INITIAL APPROVALS:

Middle School Athletic Director:                                               Recommend Approve__               Disapprove __

__________________________________________________                                                                                                  

Signature                                                                                                            Date

High School Coach:                                                                   Recommend Approve__               Disapprove __

__________________________________________________                                                                                                  

Signature                                                                                                            Date

 

High School Athletic Director:                                                    Recommend Approve__               Disapprove __

__________________________________________________                                                                                                  

Signature                                                                                                            Date

 

 

FINAL APPROVALS:

Director of Secondary Education (or designee):                 Recommend Approve__               Disapprove __

__________________________________________________                                                                                                  

Signature                                                                                                            Date

 

Encl. Student Grade Report