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Welcome to Hamburg Athletics Online Registration

SPORT - Varsity Baseball

To gain clearance to play, you must complete all registration requirements and submit a CURRENT PHYSICAL dated 02/01/2023 or after from your New York State physician.

The CURRENT PHYSICAL should be submitted by parent/guardian or directly by physician's office by email or fax as follows:

District Nurse Office

eagle@hcsdk12.org

fax: (716) 646-3304

Hamburg Bulldogs Booster Club

The Hamburg Bulldogs Booster Club mission is to support, encourage and enhance ALL Hamburg Central School District-sponsored athletic programs through fundraising efforts.

The Booster Club will share information regarding events, fundraising, and volunteer needs through email. The Hamburg Bulldogs Booster Club will not share contact information with a third party.

Select your choice below to give Hamburg Schools permission to share your name and email information with the Hamburg Bulldogs Booster Club. *

Yes - I give permission to share my name and email information with the Hamburg Bulldogs Booster Club

No - Do not share my name or email information.

PARTICIPANT INFORMATION

School Attended in 2022/2023 *

Hamburg

Other (please specify below)

If Other, Please Specify:

Parent/Guardian First Name: *

Parent/Guardian Last Name: *

Relationship to Student: *

Mother
Father
Legal Guardian
Other

Parent Guardian Phone Number, including area code: *

Parent/Guardian Email Address: *

PARENT / GUARDIAN #2

Parent/Guardian First Name:

Parent/Guardian Last Name:

Relationship to Student:

Mother
Father
Legal Guardian
Other

Parent/Guardian Phone Number, including area code:

Parent/Guardian Email Address:

EMERGENCY CONTACT #1

Contact First Name: *

Contact Last Name: *

Contact Phone Number: *

EMERGENCY CONTACT #2

Contact Phone Number:

PHYSICAL INFORMATION

To gain clearance to play, you must submit a CURRENT PHYSICAL dated 02/01/2023 or after from your New York State physician.

Date of Most Recent Physical *

I will provide my student's latest physical by: *

Email to District Nurse, eagle@hcsdk12.org
Fax to District Nurse, (716) 646-3304
Upload Current Physical Below - dated 08/01/22 or after (optional)

Optional: Please attach your athlete's UPDATED physical (front and back) dated 02/01/23 or after below

List of Allowed file types

Has participant ever been diagnosed with allergies by a health care provider? *

Yes

Does participant carry an epinephrine auto-injector (Epi-Pen)? *

Yes

Does participant have a life-threatening allergy to food, latex, medicines, foods, pollen, insect bites or stinging insects? *

Yes

If you answered yes to any of the above questions or have any general allergy information about the participant, please include below.

COMMUNICABLE DISEASES

Has the participant ever tested positive for COVID-19? *

Yes

If yes, please provide the date of the positive result.

Was the participant COVID-19 symptomatic? *

Yes

Did the participant see a healthcare provider (HCP) for their COVID-19 symptoms? *

Yes

Was the participant hospitalized? *

Yes

If yes, please provide date(s).

Was the participant diagnosed with Multisystem Inflammatory Syndrome (MIS-C) and is the participant under care for this? *

Yes

DEVICES / ACCOMODATIONS

Does participant have any special devices or prostheses (insulin pump, glucose sensor, ostomy bag, etc.)? *

Yes

Does participant wear glasses or contact lenses? *

Yes

Does participant use a brace, orthotic or other assistive device? *

Yes

Does participant wear protective eyewear, such as goggles or a face shield? *

Yes

Does participant have any protective or corrective equipment required to participate in program? *

Yes

If you answered yes to any of the above questions or have any general Device/Accomodation information about the participant, please include below.

FAMILY HEALTH HISTORY

Does participant have any relative with a heart problem, pacemaker, or implanted defibrillator? *

Yes

Does participant have any relative diagnosed with a heart condition, such as a murmur, enlarged heart, developed hypertrophic cardiomyopathy, dilated cardiomyopathy, Marfan syndrome, arrhythmogenic right ventricular cardiomyopathy, long or short QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, a heart attack at age 50 or younger, or a pacemaker or implanted cardiac defibrillator (ICD)? *

Yes

Answer NO if this question does not apply: Has participant begun having menstrual periods? *

Yes

Answer NO if this question does not apply: Does participant have regular periods? *

Yes

Answer NO if this question does not apply: Does participant have groin pain or a painful bulge or hernia in the groin area? *

Yes

Answer NO if this question does not apply: Does participant have only one testicle? *

Yes

HEAD INJURY / CONCUSSION

Has participant ever had a head injury or diagnosed concussion? *

Yes

If yes, provide date of last head injury or diagnosed concussion. (Month/Year)

Has participant ever experienced a traumatic head injury, had a hit to the head that caused headache, prolonged headache, dizziness, nausea, confusion, unconsciousness, memory loss or been told he/she had a concussion? *

Yes

Has participant ever received medical attention for a head injury? *

Yes

If you answered yes to any of the above questions or have any general Head Injury/Concussion information about the participant, please include below.

Has participant ever been told by their health care provider they have asthma? *

Yes

Does participant use or carry an inhaler or nebulizer or take asthma medicine? *

Yes

Has participant ever had a test by medical provider for his/her heart? (For example, ECG/EKG, echocardiogram stress test) *

Yes

Has participant ever been told by physician that he/she has a heart condition or problem, such as High Blood Pressure, Low Blood Pressure, High Cholesterol, Kawasaki Disease, Heart Murmur, Heart Infection, Chest Pains, New Fast or Slow Heart Rate, has Implanted Cardiac Defibrillator (ICD), has a Pacemaker or other issue? *

Yes

Does participant have a special diet or have to avoid certain types of foods? *

Yes

Has participant ever had an eating disorder? *

Yes

Does participant ever get more tired or short of breath more quickly than friends during exercise? *

Yes

Does participant ever have headaches with exercise? *

Yes

Has participant ever complained of chest pain, discomfort, tightness, or pressure DURING or AFTER exercise? *

Yes

Has participant ever complained of lightheadedness or dizziness DURING or AFTER exercise? *

Yes

Does participant wheeze, cough frequently or have difficulty breathing DURING or AFTER exercise? *

Yes

Has participant ever complained of fluttering in their chest, skipped beats, or their heart racing (irregular beats) during exercise, or does he/she have a pacemaker? *

Yes

Does participant have any problems with his/her hearing or wears hearing aid(s)? *

Yes

Does participant ever become ill while exercising in the heat/hot weather? *

Yes

Does participant have a bleeding disorder? *

Yes

Has participant ever spent the night in the hospital? *

Yes

Does participant have any ongoing medical conditions like asthma, seizures, sickle cell trait or disease, anemia, diabetes, infections or other? *

Yes

Has participant ever been restricted by a doctor, physician assistant, or nurse practitioner from sports participation for any reason? *

Yes

Has participant been diagnosed with mononucleosis (mono) within the last month? *

Yes

Does participant have any physical limitations or restrictions? *

Yes

Does participant currently receive treatment for a seizure disorder or epilepsy? *

Yes

Does participant have only one functioning kidney? *

Yes

Has participant ever had a herpes or MRSA skin infection? *

Yes

Does participant currently have any rashes, pressure sores, or other skin problems? *

Yes

Does participant have stomach problems? *

Yes

Has participant ever had surgery? *

Yes

If yes, provide date of surgery.

Has participant ever had any unexplained seizures? *

Yes

Does participant have problems with vision or has vision in only one eye? *

Yes

Does participant have to worry about his/her weight? *

Yes

Does participant have any problems with pain or swelling in muscles, tendons, bones or joints? *

Yes

Does participant have any joints that become painful, swollen, feel warm, or red with use? *

Yes

Is participant currently under the care of a Health Care Provider? If yes, please explain below. *

Yes

If you answered yes to any of the above questions or have any general Health/Medical information about the participant, please include below.

Has participant ever had any broken or fractured bones or dislocated joints? Affected areas may include head, neck, shoulder, upper arm, elbow, forearm, hands/fingers, chest, upper back, lower back, hip, thigh, knee, calf/shin, ankle, and foot/toes. *

Yes

Does participant have a bone, muscle, or joint injury that bothers him/her? *

Yes

Has participant ever had any injuries that may affect participation in a program or activity? *

Yes

In the last year, has participant had any injury that has restricted them from Physical Education class or Athletics? *

Yes

Has participant ever been unable to move his/her arms and legs, or had tingling, numbness, or weakness after being hit or falling (sometimes referred to as a stinger, burner, pinched nerve)? *

Yes

Has participant ever been diagnosed with a stress fracture? *

Yes

If you answered yes to any of the above questions or have any general Injury information about the participant, please explain and specify dates below.

POLICIES - Please click the links below to review the policy documents in a pop-up window. Clicking will not take you out of the registration page.

Eligibility Regulations and Guidelines PDF Download

My student athlete and I have read and understand the eligibility for athletes and agree to abide by the regulations and guidelines outlined.

Type your name and sign below

Clear Show me how

Student/Parent Concussion Information PDF Download

I have read and understand the NYSPHSAA Concussion Information Sheet that Hamburg Central School District will be following.

Type your name and sign below

Clear Show me how

Return To Play Protocols PDF Download

I have read and understand the Return to Play Protocols that Hamburg Central School District will be following.

Type your name and sign below

Clear Show me how

Participant Acceptance *

I hereby give my consent for my child to participate in the sport selected and to travel with the team and coaching staff to all away game venues on District provided transportation.

I understand the potential risks associated with participation in interscholastic athletics.

I am aware that Hamburg Central School District does not carry student accident insurance and all bills associated with an injury occurring during participation on an interscholastic athletic team will be my responsibility as the parent/guardian to the student athlete.

I give permission for my child's picture to be used on the HCSD website or District Twitter accounts.Yes, I agree to abide by the above conditions

Name

Submission Public, please sign Show me how

Clear

Approvals

A number of approval stages need to be completed before this submission can be accepted.

District Nurse Approval

Appropriate approvers from the District Nurse Approval group will be automatically allocated for this approval stage.

HPER Approval

Appropriate approvers from the HPER Approval group will be automatically allocated for this approval stage.

HPER: Spring 2023/24 Online Registration - Varsity Baseball

Approvals

District Nurse Approval

HPER Approval