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COUNTY'OF'RESIDENCE:'' '
Fox$Valley$Homeschool$Science$Olympiad$Team
2017:2018$Student$Registration$Form

Student$Name:$$ $ $ $ $ $ $ $ $ $ $
Student$e:mail:$$$ $ $ $ $ $ $ $ $ $
Student$age$as$of$9/1/2017:$$ $
Gender:$$!$Male$$$$!$Female
T:shirt$size:$!$Youth:Medium$$!$Youth:Large$$!$Adult:Small$$$
!$Adult:Medium$!$Adult:Large$
Student$Race:$$This%is%required%by%Illinois%Science%Olympiad%for%statistics%only.%%Your%answer%will%in%
NO%WAY%affect%involvement%with%the%team.%Other%is%not%an%option%on%their%form.%

!$White,$non:Hispanic$ !$Black/African:American$ $$$$$$!$Asian$

!$Hispanic$ $ $ !$American$Indian$or$Alaskan$Native$
!$Native$Hawaiian/Pacific$Islander$ !$Multi$Racial/Ethnic$
This$team$competes$in$day:long$competitions$held$at$very$large$regional$public$and$private$high$
schools$and$colleges.$$Students$are$expected$to$bring$their$own$lunches.$$If$your$student$requires$any$
special$accommodation$to$function$in$such$an$environment$(airborn$food$allergy,$elevator$vs.$stairs,$
etc.)$please$explain:$
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Parent$Name$&$cell:$$ $ $ $ $ $ $ $ $ $
$ e:mail:$$ $ $ $ $ $ $ $ $ $ $
Additional$Parent$Name$&$cell:$$$ $ $ $ $ $ $
$ e:mail:$$ $ $ $ $ $ $ $ $ $ $
Home$address:$$$ $ $ $ $ $ $ $ $ $ $ $$$
$110$Registration$fee$includes$one$team$shirt,$competing$in$at$least$one$invitational$event,$
and$team$workbook$to$walk$through$the$process.$$Team$registration$and$event$registration$
fees$through$State$level$competition$is$included$for$teams$who$achieve$a$qualifying$rank$at$the$
Regional$competition.$$Access$to$Fox$Valley$Homeschool$Science$Olympiad$team$supplies$
and$materials$is$made$available$to$registered$team$members.$$Students$might$not$compete$at$
Regional$competition$but$if$the$team$advances$to$State$competitionthere$is$room$for$all$to$
participate$
(please$initial$on$the$line)$
$
(next$page)$
! !
Students$of$all$faiths$and$no$faith$are$welcome$on$our$team.$$There$is$no$religious$focus$for$
this$team.$$Team$members$are$expected$to$be$respectful$of$other$team$members.$$By$initialing$
this$paragraph,$you$accept$that$your$child$and$family$may$be$involved$with$children$and$
families$of$other$or$no$faith$and$agree$that$you$can$work$together$on$the$activities$involved$
with$Science$Olympiad$in$a$respectful$manner).$
The$most$critical$focus$of$our$team$is$TEAMWORK.$$Working$with$other$students$and$families$
can$be$a$challenge.$$Anyone$who$is$unable$to$participate,$contribute$and$share$as$part$of$a$
team$will$be$asked$to$leave$without$a$refund.$$There$is$room$to$grow$(for$students$and$
parents)$but$competitiveness$within$the$team,$share$information,$or$inability$to$work$with$
others$will$not$be$tolerated.$$You$are$also$agreeing$to$bring$issues$and$challenges$to$the$
coach$EARLY$even$if$you$have$an$action$plan$for$handling$the$issue.$
Parents$realize$that$middle$school$team$members$may$need$some$guidance$and$supervision$
in$time$management$and$organization.$$By$initialing$this$paragraph,$parents$are$willing$to$help$
their$children$lay$out$a$schedule$that$peacefully$coexists$with$the$family$schedule$and$
coordinates$with$their$event$partners$as$needed.$$Parents$are$not$responsible$for$teaching$
event$content$to$their$children.$
By$initialing$here,$parent$verifies$that$the$student$does$not$take$more$than$3$classes$at$a$local$
public$or$private$school$(this$does$NOT$include:$classes$at$co:ops$where$public$schooled$
students$would$not$be$able/available$to$attend,$online$programs,$or$weekend$programs).$
By$initialing$here,$parent$acknowledges$that$they$received$the$Fox$Valley$Homeschool$
Science$Olympiad$Family$Handbook$and$has$read$or$commits$to$read$through$the$handbook$
to$become$familiar$with$team$plans,$practice$methods,$policies,$and$event$schedules$and$
expectations.$$$
You$confirm$that$your$child$has$access$to$e:mail$to$receive$and$send$e:mails$and$will$check$
this$every$day.$$
Parent$agrees$to$subscribe$at$least$one$parent$to$the$teams$Remind.com$cell$phone$service$at$
remind.com/join/fvso18.$$Text$messages$are$reserved$for$emergency$communications$
directed$to$the$ENTIRE$team.$$Messages$that$affect$your$specific$event$group$should$not$be$
sent$through$this$Remind.com$account.$
$
$
Please$fill$out$all$of$the$competition$permission$forms$and$the$medical$form.$$Competition$permission$
forms$are$kept$on$file$and$used$for$the$competition(s)$your$child$participates$in.$$Medical$forms$are$
verified$by$competition$hosts$but$have$never$before$been$collected$by$competition$hosts.$
Permission$form$for$the$Regional$competition$is$TENTATIVE$and$based$on$prior$years$assigned$
Regional$competition.$$We$will$have$final$determination$of$the$date$and$location$in$late$January.$
$
Please$return$this$at$the$first$meeting$or$mail$completed$form$and$fee$payable$to:$
$
Heather$DeGeorge$
670$Oakhurst$Court$
Naperville,$IL$60540$
$
! !

PARTICIPANT$RELEASE$FORM
ILLINOIS$STATE$SCIENCE$OLYMPIAD,$INC.

I,$______________________________$am$the$parent$or$legal$guardian$of
$(Parent/Guardian$Name$$please$print)

_______________________$$from$Fox$Valley$Homeschoolers$Science$Olympiad$Team,$
(Student$Name$$please$print)$$$$$

a$participant$in$the$tournament$sponsored$by$the$Illinois$Science$Olympiad$(ISO).

I$hereby$grant$the$ISO,$its$affiliates,$exhibitors,$sponsoring$companies$and$
participating$schools$the$full$and$unrestricted$right$to$the$use$of$my$childs$picture$
or$other$likeness$in$publicity$efforts$and$coaches$training.

I$also$give$my$child$permission$to$participate$in$the$British'International'School'Invitational
at'the'British'International'School''South'Loop'on'December'9th,'2017.

$
Signature$and$Dates:

Participant:$_____________________________________$Date:$___________

Parent$or$Guardian:$______________________________$$Date:$___________

$ $
! !

$
PARTICIPANT$RELEASE$FORM
ILLINOIS$STATE$SCIENCE$OLYMPIAD,$INC.

I,$______________________________$am$the$parent$or$legal$guardian$of
$(Parent/Guardian$Name$$please$print)

_______________________$$from$Fox$Valley$Homeschoolers$Science$Olympiad$Team,$
(Student$Name$$please$print)$$$$$

a$participant$in$the$tournament$sponsored$by$the$Illinois$Science$Olympiad$(ISO).

I$hereby$grant$the$ISO,$its$affiliates,$exhibitors,$sponsoring$companies$and$
participating$schools$the$full$and$unrestricted$right$to$the$use$of$my$childs$picture$
or$other$likeness$in$publicity$efforts$and$coaches$training.

I$also$give$my$child$permission$to$participate$in$the$Rockford'Christian'Middle'School'
Invitational at'the'Rockford'Christian'Middle'School'on'January'20th,'2018.
$
Signature$and$Dates:

Participant:$_____________________________________$Date:$___________

Parent$or$Guardian:$______________________________$$Date:$___________

$ $
! !

$
PARTICIPANT$RELEASE$FORM
ILLINOIS$STATE$SCIENCE$OLYMPIAD,$INC.

I,$______________________________$am$the$parent$or$legal$guardian$of
$(Parent/Guardian$Name$$please$print)

_______________________$$from$Fox$Valley$Homeschoolers$Science$Olympiad$Team,$
(Student$Name$$please$print)$$$$$

a$participant$in$the$tournament$sponsored$by$the$Illinois$Science$Olympiad$(ISO).

I$hereby$grant$the$ISO,$its$affiliates,$exhibitors,$sponsoring$companies$and$
participating$schools$the$full$and$unrestricted$right$to$the$use$of$my$childs$picture$
or$other$likeness$in$publicity$efforts$and$coaches$training.

I$also$give$my$child$permission$to$participate$in$the$Grayslake'Middle'School'Invitational at'
the'Grayslake'Middle'School'on'February'10th,'2018.
$
$
Signature$and$Dates:

Participant:$_____________________________________$Date:$___________

Parent$or$Guardian:$______________________________$$Date:$___________
! !
$ $
! !

PARTICIPANT$RELEASE$FORM
ILLINOIS$STATE$SCIENCE$OLYMPIAD,$INC.

I,$______________________________$am$the$parent$or$legal$guardian$of
$(Parent/Guardian$Name$$please$print)

_______________________$$from$Fox$Valley$Homeschoolers$Science$Olympiad$Team,$
(Student$Name$$please$print)$$$$$

a$participant$in$the$tournament$sponsored$by$the$Illinois$Science$Olympiad$(ISO).

I$hereby$grant$the$ISO,$its$affiliates,$exhibitors,$sponsoring$companies$and$
participating$schools$the$full$and$unrestricted$right$to$the$use$of$my$childs$picture$
or$other$likeness$in$publicity$efforts$and$coaches$training.

I$also$give$my$child$permission$to$participate$in$the$Neuqua'Valley'High'School'Regional at'
the'Neuqua'Valley'High'School'on'March'3rd,'2018.

$
$
Signature$and$Dates:

Participant:$_____________________________________$Date:$___________

Parent$or$Guardian:$______________________________$$Date:$___________

$ $
! !

PARTICIPANT$RELEASE$FORM
ILLINOIS$STATE$SCIENCE$OLYMPIAD,$INC.

I,$__________________________________________$am$the$parent$or$legal$guardian$of
$(Parent/Guardian$Name$$please$print)

_________________________________$$from$Fox$Valley$Homeschoolers$Science$Olympiad$Team,$
(Student$Name$$please$print)$$$$$

a$participant$in$the$tournament$sponsored$by$the$Illinois$Science$Olympiad$(ISO).

I$hereby$grant$the$ISO,$its$affiliates,$exhibitors,$sponsoring$companies$and$
participating$schools$the$full$and$unrestricted$right$to$the$use$of$my$childs$picture$
or$other$likeness$in$publicity$efforts$and$coaches$training.

I$also$give$my$child$permission$to$participate$in$the$Illinois'State'Tournament at'the'
University'of'Illinois'UrbanaQChampaign'on'April'21st,'2018.

$
Signature$and$Dates:

Participant:$_____________________________________$Date:$___________

Parent$or$Guardian:$______________________________$$Date:$___________

$
 MEDICAL FORM TO BE COMPLETED BY PARENTS OR GUARDIANS
For Illinois Science Olympiad Tournaments

Students Name___________________________________________________Birth Date ____________________

Parent/Guardian _____________________________________ School __________________________________
Home Address: ________________________________________________________________________________
Phone Numbers (Home/Work)_______________________________(Cell) ________________________________
Family Doctor: ___________________________________________Phone ________________________________
Insurance Carrier: _________________________________________Policy # ______________________________
In an emergency, if unable to reach parent, please contact
Name: ______________________________________________________Phone____________________________
Name: ______________________________________________________Phone____________________________
Does your child have any problems with the following, please circle the appropriate response:
Asthma yes no Environ. yes no Allergy to yes no
Allergies Insects
Seizures yes no Hearing Loss yes no Sleep Walking yes no
Diabetes yes no Heart Problems yes no Strenuous yes no
Exercise
Allergies to food yes no Allergies to yes no Diet restrictions yes no
medications

Received all the required immunizations? Yes _____ No_____ Date of last tetanus shot:_________________
Does your child have other serious medical problems or been under a physicians care recently? Yes ____ No____

If yes to any of the above problems, please, explain here or on an additional page:____________________________
_____________________________________________________________________________________________

MEDICATIONS: The student may not have any medications in his/her possession. This includes over-the-
counter medications. All medications must be given to and be held by a school representative, who will administer it
according to the written instructions. If students carry an inhaler please attach a note to this form stating and indicate
what may necessitate its use. All medications must be in the original pharmacy container and must be
delivered by the parent or guardian to the Science Olympiad Coach by a specified date to be announced.

My child may have the following medication if needed (in original container, labeled with childs name). Check all
that apply: Pain relief (Advil) _____ Cough medicine _____ Antacid_____ Other _____

List any prescription medications your child must take on a regular schedule.
Medication Dosage How Often? When?
_____________________________________________________________________________________________
_____________________________________________________________________________________________

To the best of my knowledge the above information given is correct and my child has permission to engage in all
Science Olympiad activities. In case of medical emergency, I understand that I will be notified as soon as possible
by the school representative. I hereby give permission to the physician selected by the Coach or his designee to
hospitalize, secure treatment for and to order injections, anesthesia or surgery for my child as named above. I also
give permission for my childs school representative or staff to transport my child to the hospital or medical/dental
office if needed. Any directions to the contrary should be specified at the bottom of this form and signed.

Print Name:____________________________________ Signature ______________________________________

Date: ___________________