LEBANON HBGH SCHOOL/ WARRIOR ATHLETIC CONTRACT Carefully read the following questions and B YES or NO as it applies to you. 9 10 11 12 Sport PLEASE PRINT Last Name, First Grade (Circle One) _School School You Attended LAST SEMESTER 1. PERMISSION 1 hereby give permission for my child to participate in competitive athletics and other school aetivities. 2. PHYSICAL EXAMINATION: Proof of a physical exam is required everytwo years starting in the 7 ' grade to be eligible to participate in atMetics, All participants must have a physical on file with the school PRIOR to participation. It is mandatory that the physical is on the current OSAA physical form. You can pick one up from die Athletics Office or go online at https7/www osaa.org under Quick Links click on forms and then physical examination and print one off. 3. INSURANCE: I understand that the school DOES NOT provide any medical instirance coverage. 4. ATHLETIC FEE: Each student will pay a participation fee of $100.00 per sport The fee is half price for students on the free lunch program and fidl price for students on the reduced lunch program. Full payment is required within the first two weeks of practice. If you are unable to pay at that time a payment plan must be set up With the athletic secretary. m^^£miW^^^^MSm^m£^M^mS?k Violation of Hie payment plan will restdt in suspension or disqualificationw If a student is cut from a team, the participation fee will be refunded «• If a student quits a team for any reason, other than medical or moving, after his/her first week of practice, the participation fee may not be refunded OR. transferable to another sport. •^ If the student presente the athletic director with a medical reason signed by a physician, the fee will be refunded. All medical or moving fees will be prorated. 5. I am aware playing or practicing to play/participate in any sport can be a dangerous activity involving MANY RISKS OF INJURY. I understand that tbe dangers and risks of playing or practice include, butarenotlhnitedto: death, serious injury to virtually all internal organs, serious injury or impairment of other aspects of my body, general health and well-being. I understand that the dangers and risks of playing or practicing may result not only in serious impairment of my fiiture abilities to activities, and generally to enjoy life. Because of the dangers of participating in sports, I recognize the importance of foiiowing the coaches' instructions regarding playing techniques, training, and other team rules, etc., and to agree to obey such instructions. I give my son/daughter permission to participate in competitive programs, which are approved by the board of education, and to go with the coach or other adult supervisor on regularly scheduled trips. While I expect school authorities to exercise reasonable precautions to avoid injuries, I understand that they assume no financial obligation for any injury that might occur to my soti/daughter. I am advised that students are held responsihle for all equipment owned and issued by the school. BY SIGNING BELOW I AGREE THAT I HAVE READ AND UNDERSTAND ALL INEOSMA TION ON THIS CARD. Fall Student Signature Date Paretit Signature Date Eligibility Paid Sport revised lOfiiaon Winter Spring Yes Are you currenliy enrolled in seven ( £ credil) classes? • n Did you pass frwe ( 5) oredrl classes the previous semesfer in high school? D Have you completed fouryearsofhighsdioal and/or are over 16 years of age? D Do you live wilh someone other ihan your birth parenl[s)7 If yas, wMihohi D Have you attenifed ANY high school ottiar than this one? Ifyes,where a Areyou an ewihange studenf IfVES.whatprogram • Are you enroltsd In a home school program? It YES, are you registered w/Unn-Benlon ESD? . D Did you enroll at thfe high school after the first of the school year? D Have you transferred to this high school in the past 12 months? a Are you 19? Please include birthdate (Include month/day/year) MAILING ADDRESS PHONE E-MAIL ADDRESS revised 4/28/2014 Eligibility: We will adhere to OSAA guidelines towards eligibility requirements. Students must have passed 2.5 credits the previous semester and be currently enrolled in 2.5 credits during the sport season. Any student aflilete who has a 2.0 grade point average or below will be required to complete a weekly grade report to remain eligible. Every athletic team and team member will be required to participate in weekly team study sessions regardless of GPA. The coaches as well as the atiiletic director will administer these. Online classes may jeopardize athlete's eligibility due to grading periods being different between the college and the high school. Any behavior referral, unexcused absence, or action that causes our athletic programs embarrassment will affect student eligibility. We wiU not tolerate any action that negatively impacts our school, community, as well as teammates. Drug and Alcohol Policy: It is our shicere hope that we will be able to create enough positive relationships and support for students that we wiU not have many violations of our substance abuse policy. Any student caught using or caught in a situation where other students are violating our substance abuse policy and not immediately removing themselves from the situation will be held responsible for their actions. 0 First Offense: 14 calendar days and suggested meeting(s) with school substance abuse counselor or appropriate professional, 0 Second Offense: Full suspension from the sport season or not less than a 45 day period and mandatory meeting(s) with substance abuse counselor or appropriate professional. 0 Third Offense: Full suspension from all athletic programs for the remainder of the student's high school years. Ejections: If a student athlete is ejected from a competitioD/game, the student (family) is respoQsihle for tiie fine. The first fine for a specific sport is $50. The second ejection in the same sport is a $100 fine. Each ejection thereafter in that specific sport is increased by $50 increments. (1'' - $50, 2"" - $100, 3'" - $150, 4* - $200 without limitation) A fine for an ejection in the last contest of the season shall be increased by $100 over the standard fine. OSAA policy charges each school/sport these fines, piease see www.osaa.org Handbook/Ejection Policies.