* Required

Fall Sports Participation Permission Form

By submitting this form, I am certifying that I am the parent/guardian of the student below. (Please fill out one form for each student). I understand that due to CIAC regulations, this permission form is valid for THE FALL SEASON ONLY.

Please type student's FULL, FORMAL name here​​​​​​​​

I acknowledge that my child will be screened for Covid 19 symptoms each day and they will not be allowed to participate if he/she has any of the following symptoms:

• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

I further acknowledge that participation in this activity does carry some risk of exposure to the Covid 19 virus.

In all cases of emergency treatment, I hereby give my permission to the Ellington High School staff and the Town of Ellington or its designee to select a physician for my child if I cannot be reached. I further authorize the physician to proceed with an examination, investigation, and hospitalization, necessary treatment of the injury and/or illness, and operation if needed. I also understand that EHS or Town of Ellington does not provide accident or health insurance.
I am fully aware of the risk inherent in participation in sports and hereby give my consent to the above named applicant to participate in the program and hereby release Ellington High School and the Town of Ellington, all of its members and member towns from any and all liability from injuries, claims or damages which may be sustained by my child or me on account of participation in interscholastic sports.
I have read and understand this document the “Student/Parent - Concussion Education Plan & Consent Form” and understand the severities associated with concussions and the need for immediate treatment of such injuries.​​
I have read and understand this document the “Student/Parent - Sudden Cardiac Arrest & Consent Form”.

**If you do not receive an email confirmation of this submission, it has not been received by the athletic department.**