Student Athlete Registration Form Student Athlete Full Name Last Name Last Name Parent Full Name First Name Last Name Contact Information Phone Number Email Address School Information School name Grade Level: 12th Grade11th Grade10th Grade9th Grade8th Grade7th Grade What sport(s) does your athlete play? Football Basketball Track & Field Soccer Softball Volleyball Wrestling Hockey Lacrosse Rowing Swimming Water Polo Tennis Golf Cheerleader Gymnastics What subject(s) are you most concerned with? Math English History Science Foreign Language Test Prep/Other Please tell us more about the specific concern Please include the specific class (ex: Algebra, Biology, Spanish) along with the specific concerns your student athlete is having, as well as the outcomes that you desire to see. Please list current GPA and desire GPA: Is your athlete on an IEP/504 plan? Yes No Is your athlete comfortable if we contact their coach(s)? Yes No Does your student athlete hope to compete at the college level? Yes No Do meet any of the following conditions? Free or reduced lunchSingle parent household with 1 or more siblingsLiving with someone other than your parentParent died in line of service Terms and Conditions I understand and agree to NextAthlete Academic Coaching terms & conditions. Send
