2017 Sports Registration Form
218 W Alexander StChicago, IL 60616 Phone: (312) 842-6777Fax: (312) 567-1389 StTherese@archchicago.org
Emergency Contact & Health Insurance Information
Parental Permission For Emergency Treatment
In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child, and I authorize the person in charge to take my child to: I give consent for the facility to secure any and all necessary emergency medical care for my child.
Although the safety of all sport activities is the primary concern,activities at St. Therese Chinese School's athletic and extra curricular facilities may cause injuries and/or death. I expressly assume the risk of injury, death, and/or illness arising from any cause, and agree to waive the right to pursue any claim against the St. Therese Catholic School and the persons in charge.
After completing this form, please click Submit Form. You will receive a confirmation email. If you do not receive the email within a few minutes, please check your spam; otherwise, please contact us at StTherese@archchicago.org.