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P.E. Registration Form (Fillable)

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CHET-SE PE Registration and Release Form
School Year 2024 - 2025 

I, the undersigned parent/guardian, do hereby grant permission for the child(ren) listed on this page to participate in CHET-SE PE. In order that my child/ward may receive the proper medical treatment in the event that he/she sustains injury or illness during any CHET-SE activity, I hereby authorize a supervising adult to obtain or provide medical treatment for my child/ward for such injury or illness during the CHET-SE activity, and I hereby hold CHET-SE, as well as its representatives, harmless in the exercise of this authority. I hereby release from any liability CHET-SE and all adult supervisors and class helpers in the event of any accident en route to or during activities. I further acknowledge and understand that I will be responsible for any medical bills that may be incurred on behalf of my child/ward for physical illness or injury that he/she may sustain during any CHET-SE activity.

I also understand that the PE Program includes activities such as running, jumping, stretching, and other physical exertion to benefit the students. Understanding that there is always a possibility that my child/ward may sustain physical illness or injury, I acknowledge and understand that my child/ward is assuming the risk of injury or illness by his/her participation, and I further release CHET-SE and its representatives from any claims for personal illness or injury that my child/ward may sustain during PE activities. I am aware that if my child/ward has a medical condition that prevents or prohibits him/her from participation in any PE activity (i.e. running, jumping, stretching), I must notify the PE Coach and PE Director on the day of participation. 



1. *


2. *

Home Address (street address, city, state, zip):

3. *

Cell Phone # (plus any additional phone #):

4. *


5. *




(To be contacted if parent/guardian is not available)

6. *

Emergency Contact Name and relationship to child:

7. *

Phone number(s):


Please initial that you have read and understand each of the following statements: 


I understand that PE is NOT a drop-off event and I agree to remain on the premises to be available in the event that I am needed to care for my child in ANY way. If I must leave the park, I will let the coach and PE Director know which adult remaining at the park has agreed to take responsibility for my child/ward in my absence as well as provide his/her contact number. 

8. *



I understand that should my child/ward be disruptive to the class, he/she will be asked to sit out and/or leave and will be under my supervision for the remainder of PE. 

9. *



I understand that the PE Coach or Director will speak with me directly if there is a behavior concern with my child/ward.

10. *



I understand that if I have any concerns, it is my responsibility to speak with the coach directly. If things are not resolved, I will speak with the head coach for my child’s group. If things are still not resolved, I will approach the PE Director. My final place of appeal, should the matter not be resolved, is the CHET-SE Board. 

11. *



I am solely responsible for the safety, medical and disciplinary care of my child. I am providing the following medical information only for the purpose of making others aware:


Medical information, if any:


If my child/ward needs advanced medical intervention (such as but not limited to an epi-pen or inhaler), I will remain close by to intervene should the need arise for my child/ward to have assistance. 

13. *



I understand that participation in CHET-SE PE (except as a guest) REQUIRES me to register with CHET-SE, which is a separate online registration process, requiring a separate payment. 

14. *

CHET-SE Membership Status:


Have you already paid the $25 PE Registration Fee? If so, please indicate how you paid (cash or check) and to whom you gave the fee.


Payment info, or "no":


Have you prepaid for any PE days? If so, what amount did you pay?

16. *

Amount, if any:

     For EACH child, please type: 

  • Name
  • DOB
  • PE Class: Squirrel (ages 4-5), Coyote (6-7), Cat (8-10 girl), Bear (8-10 boy), MS (11-13), or HS (14-18) 
  • (Male) -or- (Female)
  • Age of each child on September 30, 2024
17. *

Child #1


Child #2


Child #3


Child #4


Child #5


Child #6


Child #7


Child #8