Volleyball

The maximum number of form submissions has been reached. This form is currently not available.

Uniform Jersey Size REQUIRED YSM YMD YLG YXL SM M LG XL XXL Please fill out this field.
PARENTS' INFORMATION
I am the child's:
First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name 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.
Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Email REQUIRED Please fill out this field. Please enter an email address.
My Child Has the Following Health Insurance Coverage: Private Health Insurance All School Insurance through St. Rita
The Name of My Private Health Insurance Company and Policy Number is: Maximum 50 characters
Please state the name of the health insurance company that covers your child, as well as the policy number.
Please enter valid data.
Policy Holder's Name: REQUIRED Please fill out this field. Please enter valid data.
STUDENT'S INFORMATION
Name of Student/Athlete
First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Current Grade REQUIRED 5th Grade 6th Grade 7th Grade 8th Grade Please fill out this field.
Sports Physical was Completed on the Following Date: REQUIRED
Per league and Diocesan rules, a student is not allowed to participate until the sports physical has been completed and turned into the school office. A physical is valid for a period of 12 months.
Please fill out this field. Please enter a date.
Please list any and all medical information/conditions. (If none please state n/a.) REQUIRED Please fill out this field.
Name of Student's pediatrician (If none, state none). REQUIRED Please fill out this field. Please enter valid data.
Pediatrician's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
EMERGENCY INFORMATION AND PERMISSION TO TREAT
Emergency 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.
Relationship of the Emergency Contact Please enter valid data.
Permission to Treat in an Emergency
During athletic competition, there are situations that sometimes arise where a student/athlete may require emergency medical attention.

In the event we cannot be reached to obtain permission for medical attention, by clicking "I Agree" below, I hereby authorize St. Rita school, youth programvolunteers, and/or its authorized agent and employee representative(s) to act for me in an emergency or other circumstance requiring any medical treatment or attention on behalf of my child without any further permission. This consent and authorization shall include, but not be limited to, obtaining necessary hospital, medical, surgical, dental, optical, pharmaceutical, and any related care for my child and to sign any authorization therefore including admissions and/or discharges from any hospital or other care facility. I also agree to assume financial responsibility for all costs associated with medical treatment and/or transportation.

St. Rita staff will make every effort to reach the provided emergency contacts in the event of a medical issue. In most cases, parental permission will be obtained before providing treatment, especially in nonemergency situations.

I Agree Please select this field.
COACHING INFORMATION
St. Rita athletics are run almost exclusively by volunteer parent coaches. Coaching is extremely rewarding and we are always in need of qualified coaches. Would you be willing to help coach your child's team this year? Yes! Sorry, but not at this time.
Please contact me at the number below to discuss the possibility of coaching in further detail.

Submit

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Saint Rita of Cascia School

"Rejoice always, pray continually, give thanks in all circumstances;
for this is God's will for you in Christ Jesus." -1 Thessalonians 5:16-18

Volleyball

Volleyball Registration