Faith Baptist Bible College 2023-2024 Fall Sports Student-Athlete Information

Student-Athlete's First Name *

Student-Athlete's Last Name *

Gender *

Male

Female

Per new institutional policy, all fall sport athletes must arrive on Thursday, August 17th between 1-2:45 PM.

Email Address *

Cell Phone Number *

Sport(s) *

Are you a new student-athlete to this sport at Faith? *

Yes

No

Did your Major or Minor change? *

Yes

No

Social Media Information (list all usernames) *

Height *

Birthday * +

'23-'24 Year in School at Faith *

Major: *

Minor: *

High School: *

Year of HS Graduation: *

Hometown/City: *

State *

If marked other on State. Please list Province/State and Country. *

I am transferring to Faith from another college (you are considered a transfer if you attended another college as a full-time student at any point previous to this coming semester and this semester will be your first semester as a full-time student at Faith). *

Yes

No

If yes, please select one of the following two options.

I participated in a sport at the college I am transferring from.

I did not participate in a sport at the college I am transferring from.

If yes, name of institution along with the city and state:

If yes, sport(s) and seasons of competition at previous institutions i.e. 2020-2021 :

+-

First Semester entering Faith i.e. Spring of 2023: *

Other Information

Mother's Name *

Father's Name *

Parent's email address(es) *

Name of Hometown Newspaper *

For the registered sport: High School Awards/Information Please list any awards in athletics and academics you earned in high school. Ex: First-Team All-State, team captain (what year), First-Team All-Conference, National Honor Society member, valedictorian, MVP etc. *

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NCCAA Certificate of Clearance

Institution: Faith Baptist Bible College State: Iowa

In accordance with the Family Educational Rights and Privacy Act, I, the undersigned, hereby authorize the Compliance Officer, Athletics Director, and Registrar of the institution I am attending to release any and all information about me which pertains to my eligibility to participate in intercollegiate athletics. The release of such information shall be restricted to any and all official representatives of the NCCAA and its member representatives if applicable), only for the purpose of determining my eligibility for intercollegiate athletics. It is further understood that I may receive copies of such material from the institution upon request. This is for the academic year of 2023-2024.

The above statement is applicable for the sport of *

Student-Athlete's First Name *

Student-Athlete's Last Name *

Today's Date * +

By signing below you hereby certify that you have read and understood NCCAA Certificate of Clearance statement above. *

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Faith Baptist Bible College Athletic Department Assumption of Risk

I am aware that playing, practicing, training, and/or other involvement in any sport can be a dangerous activity involving MANY RISKS OF INJURY, including, but not limited to the potential for catastrophic injury. I understand that the dangers and risks of playing, practicing, or training in any athletic activity include, but are not limited to, death, serious neck and spinal injuries which may result in complete or partial paralysis or brain damage, serious injury to virtually all bones, joints, ligaments, muscles, tendons, and other aspects of the musculoskeletal system, and serious injury or impairment to other aspects of my body, general health and well being. Because of the aforementioned dangers of participating in any athletic activity, I recognize the importance of following all instructions of the coaching staff, strength and conditioning staff, and/or Athletic Training staff. Furthermore, I understand that the possibility of injury, including catastrophic injury, does exist even though proper rules and techniques are followed to the fullest. I also understand that there are risks involved with traveling in connection with intercollegiate athletics.

In consideration of Faith Baptist Bible College permitting me to participate in intercollegiate athletics and to engage in all activities and travel related to my sport, I hereby voluntarily assume all risks associated with participation and agree to hold harmless, indemnify, and irrevocably and unconditionally release Faith Baptist Bible College, and their officers, agents, and employees from any and all liability, any medical expenses, and any and all claims, causes of action or demands of any kind and nature whatsoever which may arise by or in connection with my participation in any activities related to intercollegiate athletics.

The terms hereof shall serve as release and assumption of risk for my heirs, estate, executor, administrator, assignees, and all members of my family.

I fully understand that this authorization shall be effective and valid for one year (52 weeks) after the termination of my playing and/or academic career at Faith Baptist Bible College.

Student-Athlete's First Name *

Student-Athlete's Last Name *

Today's Date * +

Athlete's Age Today *

18 or Older

Younger than 18

Date of Birth * +

This acknowledgement shall be in effect from the date this document is signed and shall remain in effect until the subsequent Faith Baptist Bible College Athletic Department Assumption of Risk form is executed.

Student-Athlete's Signature *

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Print Name Parent/Guardian (if student-athlete is a minor) *

Today's Date * +

Parent/Guardian's Signature *

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