Stokes County High Schools Athletic Participation Requirements
Name of Parent/Guardian:
Student-Athlete:
Street Address:
School:
City:
State:
Zip Code:
Date of Birth
Grade:
Phone: HomeWorkCell-
Emergency Contact Name:
PhoneCellAthletic Eligibility - Academics: A student must have passed a minimum load of work during the preceding semester to be
eligible at any time during the present semester and must also meet local promotion standards.
A minimum load is defined as three courses for a “block schedule”
Rising 9th graders enter with academic and attendance exemption for the 1st semester.
Athletic Eligibility - Attendance: The student-athlete must be enrolled within the first 15 days and in regular attendance for
the present semester to be eligible for athletics.
A student-athlete must have been in attendance for at least 85 percent, may not miss more than 13 (thirteen) days of the
previous semester at an approved high school.
Athletic Eligibility – Eight Semester Rule: No student may be eligible to participate at high school level for a period lasting
longer than eight consecutive semesters, beginning with the student’s first entry into grade nine, or participation on a high
school team as an overage seventh-or eighth-grade student, whichever comes first. For students who skip the ninth grade and
advance directly to the 10th from the eighth, the year prior to entering the 10th grade is considered the year of first entry into
ninth grade for athletics.
Athletic Eligibility - Change of Residence or Special Transfer: Must live with parent(s) or legal custodian within the
school administrative unit (exceptions must be approved by the principal and the NCHSAA). A student-athlete is eligible
if he/she has attended school within that unit the previous two semesters (if eligible in all other respects).

Must not falsify any official eligibility information such as residency/address. Penalty for such acts will result in loss of
eligibility for 365 days.

A release from domicile school system must be on file with Stokes County Schools prior to student-athlete practicing or
playing in a sport.
[ ] Place checkmark in brackets verifying that address listed above is correct
Insurance:
Check one: [ ] School Accident Insurance [ ] Name of Other Insurance Company
Insurance Company Name: _____________________________________
Policy Number: ______________________ Group Number: ____________________
 It is the responsibility of parent(s)/guardian(s) to notify the athletic director of any changes in insurance.
Photographic/Video Permission: I consent to the Stokes County Schools use of photographs and videos of the herein named
student’s name for use in news letters or publications produced by the school system. Also by the news media in school
related coverage.
NCHSAA Regulations Student Athlete Pledge: As a student-athlete, I am a role model. Using inappropriate language;
taunting; baiting; or the use of unwarranted physical contact directed at opposing players, coaches and fans are contrary to the
spirit of fair play and the good sportsmanship my school, my conference and the NCHSAA expects of its members. I accept
my responsibility to model good sportsmanship that comes with being a student- athlete.
[ ] Place checkmark in brackets verifying that student-athlete has not been convicted of a felony.
Parent Pledge: As a parent, I am a role model. I will remember school athletics are an extension of the classroom, offering
learning experiences for the students. I will show respect for the opposing players, coaches, spectators and support groups. I
will participate in cheers that support and uplift the teams involved. Using inappropriate language and taunting are contrary
to the spirit of fair play and the good sportsmanship our school, our conference and the NCHSAA expects of its members. I
accept my responsibility to model good sportsmanship that comes with being the parent of a student-athlete. I certify that the
home address as parent(s)/guardian(s) shown in this document is my sole bona fide residence and I will notify the school
principal immediately of any change in residence, since such a move may alter the eligibility status of my student-athlete. All
other information contained in this form is accurate and current.