CSCS MS Athletic Packet 2018-19

Colorado Springs Christian Middle School

Athletic Department

Athletic Forms Packet2nd SPORT

Nam

e (Last, First): Grade:

Sport:

All forms must be turned in as a packet. Please check to be sure all forms are included and signatures are in place. Participation will not be allowed unless all forms are turned in. Please do not staple forms together.

Check List:o Emergency/Contact Informationo Permit for Participationo Athletic Fee Form with Payment(s)

CSCS MS Athletic Packet 2018-19

Colorado Springs Christian Middle SchoolAthletic Emergency/Contact Form

Player's Name: Grade: Sport:

Birthdate:

Parent/Guardian’s Name:

Home Phone:

Work Phone:

Cell Phone:

Email:

Additional Emergency Contact Name(s):

Emergency Contact Phone Number: Cell Work Home

Physican Name:

Insurance Company: Policy#

Hospital Preference:

Chronic Ailments:

Consent For Emergency Treatment for Interscholastic Activity Injuries

I, , parent or guardian of

in consideration of my son’s/daughter’s opportunity to participate in interscholastic activities,

hearby consent to emergency medical treatment, hospitalization or other medical treatments

as may be necessary for the welfare of the above named child, by physican, qualified nurse,

and/or hospital, in the event of injur or illness during periods of time in which the student is

away from his/her legal residence as a member of an interscholastic activity team or group,

and herby waive on behalf of myself and the above named child any liability of the School, and

any of its agents or employees, arising out of such medical treatment.

Parent/Guardian Signature: Date:

(Parent Name) (Student Name)

CSCS MS Athletic Packet 2018-19

Colorado Springs Christian Middle SchoolPermission for Participation

Warning: Although participation in supervised interscholastic athletics and activities may be one of the least hazardous in which any student will engage in or out of school, BY ITS NATURE, PARTICIPATION IN INTERSCHOLASTIC ATHLETICS INCLUDE A RISK OF INJURY WHICH MAY RANGE IN SEVERITY FROM MINOR TO LONG-TERM CATASTROPHIC INJURY AND PERHAPS, FATAL ACCIDENTS MAY OCCUR. Although serious injuries are not common in supervised athletic programs, it is impossible to eliminate the risk.

Students and parents must assess the risk involved in such participation and make their choice to participate in spite of those risks. No amount of instruction, precaution, or supervision will totally eliminate all risk of injury. Just as driving an automobile involves choice of risk, athletic participation also may be inherently dangerous. The obligation of parents and students in making this choice to participate cannot be overstated. There have been accidents resulting in death, paraplegia, quadriplegia and other very serious physical impairment as a result of athletic competition.

PLAYERS MUST OBEY ALL SAFETY RULES, REPORT ALL PHYSICAL PROBLEMS TO THEIR COACHES, FOLLOW A PROPER CONDITIONING PROGRAM, AND INSPECT THEIR OWN EQUIPMENT DAILY.

By signing this PERMISSION FORM, I acknowledge that I have read and understood this warning. PARENTS OR STUDENTS WHO DO NOT WISH TO ACCEPT THE RISKS DESCRIBED IN THIS WARNING SHOULD NOT SIGN THIS PERMISSION FORM.

I hereby give consent for to compete in athletics for Colorado Springs Christian Schools.

Parent/Guardian Signature Date:

(Student Name)

No student shall represent their school in interscholastic athletics until there is on file with the superintendent or principal a statement signed by their parent or legal guardian, a signed physical certifying that he/she has passed an adequate physical examination within the past year, that in the opinion of the examining physician, physician’s assistant, nurse practitioner or a certified registered chiropractor, he/she is physically able to participate in athletics; and that he/she has the consent of his/her parents or legal guardian to participate.

Note: It is strongly recommended by the Colorado Department of Health that individuals participating in athletic events have current tetanus boosters. Tetanus boosters are recommended every 10 years throughout life. Boosters are recommended at the time of injury if more than five years have elapsed since the last booster.

If a student athlete has been injured in practice and/or competition, the nature of which required medical attention, the student athlete should not participate or return to practice and/or competition until he/she has received a release from a practicing physician.

CSCS MS Athletic Packet 2018-19

Student Athlete Name: Grade: Sport:

Parent/Guardian’s Signature: Date:

Colorado Springs Christian Middle SchoolAthletic Fees

Fees By Sport: l 6th grade Basketball and Volleyball $40 to CSAL and $35 to CSCS l 6th grade Cross Country, Soccer and Wrestling $35 to CSCS l 7th & 8th Volleyball: $60 to CSCS (If CSAL team is formed, add $40) l 7th & 8th Football: $60 to CSCS l 7th & 8th Cross Country: $60 to CSCS l 7th & 8th Soccer: $60 to CSCS l 7th & 8th Basketball: $60 to CSCS l 7th & 8th Wrestling: $60 to CSCS l 7th & 8th Track: $60 to CSCS

l Non-traditional athletes have different fee structure. See the athletic director for these fees.

Please enclose payment(s) with the sports packet