THESA Athlete Application

Check one: High School (9-12)_____ Middle School (6-8)_____

Activity (Circle One):          Girls: Volleyball; Basketball; Softball         Boys: Baseball; Basketball; Football; Golf

Sponsor: Texas Home Educators Sports Association, Inc. (THESA)  (A THESA family membership application must be completed upon making a team.)

Name of Player ___________________________________________________

Address ___________________________________________City___________________________ ZIP ___________

Home Phone __________________Dad’s Work__________________Mom’s Work_______________

Birthdate ______________________ Grade_________ Age today _________

Parents' Names:__________________________________ Dad’s Cell: __________________ Mom’s Cell: ___________________

Parents’ email____________________________Player’s email or secondary email___________________

How many years have you been educated at home? _______ Do you meet THESA eligibility requirements? _________

Attending any organized school classes? _______If yes, what school and how many courses? _______________________________

How many years have you played this sport?____________At what level and what positions?_______________________________

Any physical limitations?  ______   If yes, please describe on back of sheet.

By submitting this Application you agree to abide by all of THESA rules including the Athletic Handbook and Eligibility Requirements at all times. (see www.thesariders.org ‘important links section’ for these documents)

Permission and Release of Liability: I give permission for my child to participate in this activity and I hereby declare that my child is physically able to participate in strenuous activity such as competitive athletics and any tryouts. In the event he/she is injured, I waive and release all rights to any claim for damages against the sponsor or its representatives. I further agree that any claim or dispute arising from or related to this agreement shall be settled by mediation and, if necessary, legally binding arbitration, in accordance with the Rules of the Institute for Christian Conciliation; judgment upon an arbitration award may be entered in any court otherwise having jurisdiction. I understand that THESA may not carry medical insurance for players or coaches and I am fully responsible for any and all medical bills (THESA may have a secondary medical policy if needed).

Medical Release: In the event my child suffers sudden illness, accident, or injury and neither parents nor guardians can be contacted or are otherwise not available, I give permission for any emergency treatment that is deemed necessary by a licensed physician or emergency personnel.

Family physician ____________________________________________Phone ____________________

List pertinent medical information below and alert coaches to any serious ailments or concerns (diabetes, allergies, asthma, etc.):

For Athletes:  “As a THESA participant, I will promote Christ-like sportsmanship through playing fairly, respecting authority, and being a positive loser and a gracious winner. I will also promote Christ-like character through faithful attendance and participation in all sporting events and fundraisers. My attitude and appearance will reflect Christ at all times.” “I will also abide by all of THESA rules including the Athletic Handbook and Eligibility Requirements at all times.”

For Parents:  “As the parent of a THESA participant, I will model and promote Christ-like sportsmanship through giving positive encouragement, respecting authority, and being a positive loser and a gracious winner.”

By signing this form you are agreeing to all statements above, including, but not limited to, release of liability and medical treatment. (Parent signature for player under 18.)

Parent’s signature: _______________________________ Date:_________________

Parent’s signature: _______________________________ Date:_________________

Player’s signature:________________________________ Date: ________________