Powder Puff 2025 – 10th Grade Player Registration

Student First Name *

Student Last Name *

Date of Birth *

Grade: 10th

Homeroom Teacher

Cell Phone # *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

T-shirt Size *

In compliance with local school policy, which requires students who participate in activities such as Powder Puff to have adequate insurance protection, the following information must be completed.

Company Providing Insurance *

Name of Insured *

First

Last

Policy Number *

Select to Authorize *

I certify that my child is physically fit and in proper physical condition to participate in Walton High School’s Powder Puff activites.
In case of emergency or accident on the school grounds or during this school activity involving my child which, in the opinion of school authorities present, requires immediate medical or surgical attention, I hereby grant permission to said school authorities to obtain the services of a physician or to transport said child to the hospital if it is deemed necessary by school authorities. I hereby grant permission, also, to said physicians to treat said condition unless I am present and request otherwise, or until I later request otherwise.
My child is adequately and currently covered by accident insurance that will cover injuries sustained while participating in Powder Puff 2025.

Hospital Preference, if other than Kennestone

To ensure medical care, if needed, an ambulance has been reserved for the Powder Puff game. It is their policy to take an injured student to the nearest hospital, which is Wellstar Kennestone Hospital. If a choice is possible, please list your hospital preference.

Parent/Guardian Signature *

Clear Signature

Parent/Guardian Name *

First

Last

Date Signed *

Relationship to student *

Powder Puff Player Registration – Grade 10

Price: $30.00

$30.00 Registration fee required to complete the registration.

Powder Puff 2025 – 10th Grade Player Registration

Grade: 10th

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