Clone of Math Pentathlon D3, Winter 2025

Math Pentathlon Division III (4th/5th) Registration

O'Hara Elementary - O'Hara Foxes Club

We're excited to welcome your students to Math Pentathlon this winter! See this website for full details about the program. You can also email the chairs at mathpen@oharapto.org.

This form is for DIVISION III (4th/5th) ONLY. Due to the school's dismissal logistical constraints, different divisions meet on different days and have enrollment limits. To support those limits, each division has a separate registration form.

D3 Math Pentathlon sessions will run Mondays from January 26 through March 2, 2026, excluding Monday, February 16 (President's Day, no school). Game Day is Saturday, March 7th at DMS for all divisions.

Division I	K/1st	Wed	Registration
Division II	2nd/3rd	Fri	Registration
Division III	4th/5th	Mon	THIS FORM

Student Info
Student Name*

First NameLast Name
Student Grade*
If you don't see your child's grade listed, see the instructions at the top of the form.
Student Homeroom Teacher*
Including this year, how many years will the student have participated in Math Pen?*
This will determine the correct ribbon color for the student's Game Day medal.
Student T-Shirt Size*
Youth T-shirt size measurements

Adult T-shirt size measurements
Parent/Guardian/Emergency Contact Info

Phone numbers are required for emergency situations. The primary contact must also include an email address for program logistics emails, and the second contact may optionally do so.
Primary Contact Name*

First NameLast Name
Primary Contact Email*
example@example.com
Primary Contact Phone*

Area CodePhone Number
Contact #2 Name*

First NameLast Name
Contact #2 Email
example@example.com
Contact #2 Phone*

Area CodePhone Number
Sign Out Authorization
After each practice:*

I will arrange to have my child picked up promptly between 4:45–5:00 pm. I or my designees will be prepared to show ID to sign out my child(ren).My child should be dropped off with the YMCA after-school program at O'Hara.
Besides the contacts already listed above, the following people are also authorized to sign out my student:
LAWCC: Students who normally go to LAWCC after school MUST be picked up at the school between 4:45-5:00pm. There is no option to return to LAWCC.
Volunteering

This program is one of O’Hara’s biggest, and it is only possible through the support of volunteers. As such, each participant should have a volunteer commit to at least two practice sessions, handing out and collecting game materials, answering student questions, and generally helping out as needed.
Is there a parent or guardian (or other volunteer) WITH CLEARANCES?*
Sign up form: Signup Genius
I have signed up for volunteer slots at the Signup Genius link above*

YesAll slots for my grade(s) are already filled, but I'll help out if more slots open up
Student Medical Information
Does your child have any allergies (e.g. nuts, medicine, etc.) or medical conditions (e.g. diabetes, asthma, etc.) to be aware of or pass on to medical providers in case of emergency? *
Enter n/a if none.
Releases
If emergency medical care is necessary and I cannot be reached, I/we authorize the O'Hara PTO to act on my behalf in granting permission for my child to receive emergency medical services. Parents/guardians are responsible for all expenses incurred as a result of medical treatment.
I/We authorize O'Hara PTO to produce photographs or video of my student(s) for the purposes of community education and/or program promotion. I/We understand that I/we can revoke this media release at any time by contacting the O'Hara PTO Board of Directors.
I/We, on behalf of myself and my minor child(ren), agree to release, hold harmless and indemnify O'Hara Elementary Parent Teacher Organization and its volunteers, officers, and agents, from any loss, cost, damage and/or expense of any nature, including all attorneys’ fees and costs which I or my child(ren) may have resulting, either directly or indirectly, from my child(ren)’s participation in Math Pentathlon.

By signing this Agreement, I/we acknowledge that we have read and understand this release of liability and accept the risk and responsibility of participation in Math Pentathlon.
Electronic Signature*

Clear
Adult T-Shirts
(2023 design shown, 2025 design pending but will be the same general vibe though short sleeve instead of 3/4)

An official O'Hara Math Pen youth T-shirt is included with every student registration. There is also an option for adults to buy a T-shirt and show O'Hara spirit on Game Day or all year round! Adult shirt size measurements

If you want to purchase optional adult T-shirt(s), please indicate the size(s) below. (If paying by cash/check, be sure to include an extra $17/shirt with your payment.)

	Quantity
Adult S
Adult M
Adult L
Adult XL
Adult 2XL
Adult 3XL
Adult 4XL

Payment Information
- If paying by check or money order, please make out to OEPTO and send to the school. Include the student's name and Math Pentathlon in the memo.
- Cash should be sent in a sealed envelope Attn: O'Hara PTO/Math Pentathlon with your student's name.
- Payment must be received one week before class starts or your child's spot could be forfeited. All payments are final. No refunds will be given if unable to attend all sessions.
- If you need scholarship assistance for this program, please choose the cash option above and contact your school counselor.
How will you pay? *

Please ensure you have selected the correct quantities for adult T-shirts for your credit card payment before submitting. (Unfortunately, Jotform does not allow for setting them automatically based on your form responses.)
Should be Empty:

Math Pentathlon Division III (4th/5th) Registration

Student Info

Parent/Guardian/Emergency Contact Info

Sign Out Authorization

Volunteering

Student Medical Information

Releases

Adult T-Shirts

Payment Information

Payment Methods