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Athletics Registration Form

- 2022-2023 Winter Sports Sign Ups are closed
  
  The maximum number of form submissions has been reached. This form is currently not available.
  
  Thank you for your interest in our sports programs. Fees will be billed and payable through Fast Direct. If you have any questions, please contact our Athletic Director, Julie Roy.
  
  Pay to Play Fee - $75
  
  A fee reduction or full fee waiver
  may be available on an as needed basis.
  
  Please contact our Athletic Director for more information.
  
  Sport REQUIRED Please fill out this field.
  
  Student Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  T-Shirt Size
  
  Parent/Guardian Name REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Home Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Mobile Phone Number Maximum 20 characters Please enter a phone number.
  
  Insurance Provider REQUIRED Please fill out this field. Please enter valid data.
  
  Primary Doctor's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Hospital Preference REQUIRED Please fill out this field. Please enter valid data.
  
  Allergies/Medication REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Name REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  I give my child permission to participate in St. Brigid Sports for the 2022-2023 season.
  
  I Agree Please select this field.
  
  Any questions? Contact Julie Roy, Athletic Director.
  
  Submit
  
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- Contact Us
  
  Julie Roy
  
  Athletic, Aftercare, and Summer Program Director
  
  julie.royportlanddiocese.org