High School Athletics Hardship Waiver Form
Use this form to request hardship-based consideration for high school athletics participation and to provide the information and supporting details needed for review.
Student-Athlete Information
Student-Athlete Full Name
*
First Name
Last Name
Grade Level
*
Please Select
9th Grade
10th Grade
11th Grade
12th Grade
School Name
*
Date of Birth
-
Month
-
Day
Year
Date
Primary Sport(s)
*
Football
Basketball
Baseball
Softball
Soccer
Track & Field
Volleyball
Wrestling
Swimming
Tennis
Cross Country
Golf
Lacrosse
Other
Team / Coach Name
Parent/Guardian and Contact Information
Parent/Guardian Full Name
*
First Name
Middle Name
Last Name
Relationship to Student-Athlete
*
Please Select
Parent
Guardian
Step-Parent
Other
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Preferred Contact Method
*
Phone
Email
Either
Hardship Request Details
Hardship Reason Category
*
Financial hardship
Family emergency
Transportation issue
Illness or injury in family
Schedule conflict
Other
Detailed Explanation of the Hardship
*
Date Hardship Began or Was Identified
*
-
Month
-
Day
Year
Date
Nature of Hardship
*
Temporary
Ongoing
Dates or Season Affected
Athletics Participation Context
Sport/Season
*
Please Select
Fall
Winter
Spring
Year-Round
Other
Current Team Level or Program
*
Please Select
Freshman
JV
Varsity
Club
Intramural
Other
Specific Participation Issue Requiring Waiver Consideration
*
Prior Approval Requested from Coach or Athletic Staff?
*
Yes
No
Supporting Details About Attendance, Eligibility, or Missed Requirements
Supporting Documentation
Upload Supporting Documents
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Document Description / File List
Waiver Acknowledgment and Authorization
Parent/Guardian or Eligible Student Signature
*
Submit Request
Submit Request
Should be Empty: