mcmaster coaches handbook 2013-2014
DESCRIPTION
Schedules, forms and guidelines for Marauder coaching staff.TRANSCRIPT
2013-14 COACHES HANDBOOK
2013-14 COACHES HANDBOOK
Contents OUA/CIS Contact Information
McMaster Coaches Information
Athlete Eligibility
Athlete Recruiting
SFAS & AFA
Travel
US Travel
Media
Meetings & Deadlines
Facility Booking
Financial Information
Cash Control Protocol
Gift Certificate Protocol
Sport Med
Bracing
Injury/Incident Reports
Student Wellness Centre
Hospital Directions
Emergency Procedures & Safety Guidelines
Parking, Apparel & Quick Links
Strength and Conditioning
Bastable Resource Centre
Ontario University Athletics (OUA)
1119 Fennell Ave. E., Suite 230 Hamilton, Ontario L8T 1S2
Phone: (905) 540-1966 Fax: (905) 574-2840
Executive
Jennifer Myers President 416-736-5968 [email protected]
Sport Programming & Development
Bryan Crawford Sport Programming Manager 905-540-5148 [email protected]
Samantha Magalas Sport Development Officer 905-667-2558 [email protected]
Meredith Walker Sport Administrative Assistant 905-540-1966 [email protected]
Phil D'Alessandro Finance Clerk 905-540-1966 [email protected]
Marketing & Communications
Katie Mueller Marketing & Communications Manager (Interim) 905-540-5150 [email protected]
Jessica Barrett Communications & New Media Coordinator 905-540-5156 [email protected]
Cory Wright Communications Assistant 905-667-2570 [email protected]
www.oua.ca
Canadian Interuniversity Sport
801 King Edward, Suite N205 Ottawa Ontario Canada K1N 6N5
Phone: 613-562-5670 Fax: 613-562-5669
Title & Name Phone Email
Chief Executive Officer
Pierre Lafontaine 613-562-5670, Ext. 26 [email protected]
Manager, Events & Programs
Sheila-Ann Newton 613-562-5670, Ext. 23 [email protected]
Director, Operations & Development
Tom Huisman 613-562-5670, Ext. 22 [email protected]
Communications & Media Relations
Michel Belanger 613-562-5670, Ext. 25 [email protected]
Marketing
Gord Grace 226-350-7760 [email protected]
Webmaster, Statistician, Social Media
Manager, and Communications
Assistant
Jason Ilacqua
613-562-5670, Ext. 27 [email protected]
Director, Finance & Administration
Debbie Villeneuve 613-562-5670, Ext. 24 [email protected]
Manager of Sport and International
Programs
Mary MacDonald
613-562-5670, Ext. 32 [email protected]
Members Services Officer
Krista-Lee Robinson (613) 562-5670 ext. 21 [email protected]
www.cis-sic.ca/splash/index
* - denotes Club sport P – denotes Club President
SPORT COACH EMAILBadminton – M & W TBDBadminton * Vincent Wu (P) [email protected] Wayne Gowan [email protected] – M Amos Connolly [email protected] – W Theresa Burns [email protected] Jujitsu * Mike Hissink (P) [email protected] * Marcy Kuzemcak/ Virginia Abel (P) [email protected] * TBA [email protected] Country Rory Sneyd [email protected] Chris Malcolmson [email protected] * TBA [email protected] Ken Oda [email protected] Dave O’Donnell [email protected] Hockey * Claire Layton (P) [email protected] Skating * Riley Allison (P) [email protected] Stefan Ptaszek [email protected] Football – W * Katie Penney (P) [email protected] – M & W Alf Callowhill [email protected] * Pri Randeria/Courtney Wood (P) [email protected] – M * Rob Wilkenson [email protected] – W * Kendra Young (P) [email protected] Fu * Qudsia Shaheen (P) [email protected] – M Jason Tallevi [email protected] – W Silvana Yee [email protected] * Meghan Chouinard (P) [email protected] – M & W * Mel Remy (P) [email protected] – M Phil White [email protected] – W Cam Mitchell [email protected] * Elizabeth Krock (P) [email protected] – M Dino Perri [email protected] – W Brett Mosen [email protected] – M Abdul Khalul [email protected] – W Doug Hamilton [email protected] – M & W Andrew Cole [email protected] Swim * Justine Bentley (P) [email protected] Kwon Do * TBA [email protected] – M Rasim Sehovic [email protected] – W Peter Patiakas [email protected] Paula Schnurr [email protected] * Sean Coombes (P) [email protected] Dance * Amanda D’Guilio (P) [email protected] – M Dave Preston [email protected] – W Tim Louks [email protected] – M & W Quinn Fairley [email protected] Nick Cipriano [email protected]
COACHES CONTACT LIST 2013-2014
STUDENT-ATHLETE ELIGIBILITY
Student-athletes are required to complete the on-line student-athlete registration process (via
MUGSI) where they will find all the necessary forms for athlete clearance.
PRE-SEASON
To be cleared to play, every student-athlete must:
Be financially registered (on-line Payment Agreement MUST be done before first game –
exhibition or league)
Complete medical screening process and be cleared to participate by Sport Medicine
Comply with OUA/CIS policies when applicable.
Complete CCES online anti-doping course (CIS sports only)
IN-SEASON
Additions to a team’s roster must be made in enough time for the student-athlete to be
declared eligible
Deletions need to be communicated to the Athlete Services Coordinator
Only dress student-athletes that appear on the Eligibility Certificate
POST-SEASON
CIS coaches will receive an updated Eligibility Certificate from the Athlete Services
Coordinator indicating those student-athletes who DID and DID NOT use a year of
eligibility (see below for criteria).
OUA ELIGIBILITY
For a complete copy of OUA eligibility policies, visit:
http://www.oua.ca/sports/2011/7/15/Student%20Eligibilty.aspx
The Basics…
There is no maximum number of years a student-athlete can compete in an OUA sport.
All student-athletes must pay an athletic fee to the institution in which they are enrolled.
Student-athletes must be enrolled in a minimum of 9 units in the term in which they are
competing within OUA or registered as “full-time” by their faculty (if they are a graduate
student)
To continue participation in the following year, a student-athlete must have successfully
completed a minimum of 18 units during the previous year (September – August).
Student-athletes may transfer from one institution to another without penalty, provided all
other eligibility requirements are met.
CIS ELIGIBILITY
For a complete copy of CIS eligibility policies, visit:
http://english.cis-sic.ca/information/members_info/eligibility_package
The Basics…
CIS student-athletes have a maximum of five (5) years of eligibility
Academic Requirements
Student-athletes must be enrolled in a minimum of 9 units in the term in which they are
competing within CIS or registered as “full-time” by their faculty (graduate students)
To continue participation in the following year, a student-athlete must have successfully
completed a minimum of 18 units during the previous year (September – August).
To regain eligibility…Any student-athlete, who is ineligible to compete because they are no
longer a student in good standing, must first successfully complete 18 units within an
academic year before becoming eligible to compete.
Athletic Requirements
Name on score sheet = participation
A year of eligibility will be charged where the athlete has participated in any one of the
following:
o Participation in three or more non-conference competitions or tournaments
o Basketball, Soccer & Volleyball*
Participation in 1 conference competition if there is a non-conference
schedule
Participation in 2 conference competitions if there is not a non-conference
schedule
o Football & Rugby*
Participation in 2 conference competitions (regardless of non-conference
schedule)
*NOTE: Irrespective of the participation of the student-athlete in the non-conference schedule.
o Cross-Country, Swimming, Track & Field, Wrestling
Participation in 3 non-conference competitions or tournaments (all
competitions outside of OUA or CIS championship are considered non-
conference)
o Any participation in OUA playoffs/qualifications to CIS championship
o Any participation in a CIS Championship
A non-conference or exhibition competition shall be recognized as such if any one of the
following conditions exists:
o The competition is scheduled and publicized in advance;
o Official score is kept;
o Individual or team standings are maintained;
o Admission is charged;
o Teams are regularly formed or team rosters are predetermined
o Team uniforms are utilized
Transfer Rule – In most cases, an athlete, who has participated in a recognized sport of
CIS, at a CIS or NCAA institution, shall not be eligible to participate until 365 days from
their last competition at their previous institution.
If you have any questions regarding eligibility, please contact Claire Arsenault, Athletic
Coordinator, at ext. 23628 or [email protected]
MCMASTER MARAUDERS RECRUITING HANDBOOK
We all understand that the biggest reason for continued success in athletics is the recruitment of quality
student-athletes. Here are a few important things to know in regards to recruiting student-athletes and
the admissions process at McMaster University.
Every student, whether a regular Ontario high school graduating student, an out-of-province student, or
a transfer student from another post-secondary education institution, must apply for university
acceptance through the Ontario University Application Centre (www.ouac.on.ca)
The information sent to the OUAC will be forwarded to all Ontario universities these students have
selected to apply to. McMaster University will be sent the information on each applicant (i.e.
transcripts from high school and/or previous academic institution).
Please remember that McMaster University’s Department of Athletics and Recreation have NO say in
whether students are accepted at McMaster or not…they must have a minimum of 75%* to be granted
admission.
Here is a list of steps the students must go through to be accepted to McMaster University:
1. Apply to all Ontario universities through www.ouac.on.ca (deadline mid-January)
2. Select McMaster University as one of their choices.**
3. Send in all relevant paperwork (i.e. transcripts, etc.) to the OUAC office.
4. Wait for a decision to be made.
5. Receive the letter from McMaster offering admission for the upcoming semester.
6. Answer McMaster by returning the offer with an answer before the deadline (late May/early
June)
7. In order to keep a residence sport, the student-athlete should also complete the online
application and deposit by the same deadline (late Mat/early June)
*75% is the minimum cut-off for Humanities; other programs could have higher requirements. The
requirements change on an annual basis.
**It has been found that students who enter McMaster University as their 4th
choice or less on their
OUAC application, are not very serious as to their intentions of attending McMaster. Be careful how
you spend your energy on these people!
UNIVERISTY OFFERS
McMaster’s Registrar’s Office begins to send out offers as early as January for out-of-province,
international, transfer students and early March for Ontario high school students. From that point on,
admissions will be on an ongoing basis. Any time there is an update of marks through the system;
newly qualified students will be sent their letters of admission. That process will continue until late
May.
The established cutoffs from each faculty will vary from year to year. Here are the admission cutoffs
used for 2013 incoming students:
Program Grade 12 Averages
Arts & Science** minimum 88% (by selection)*
Bachelor of Technology 75%
Business 84%
Computer Science 86%
Engineering 87%
Environmental & Earth Science 84%
Bachelor of Health Sciences** minimum 90% (by selection)*
Humanities 75%
Integrated Science high 80s (by selection)*
Kinesiology 89%
Life Sciences 88%
Mathematics & Statistics 84%
Medical Radiation Sciences 86%
Midwifery minimum 80% (by selection)*
Music 75% (and audition)
Nursing 89%
Physical Sciences 84%
Social Sciences 78%
Studio Art minimum 75% + portfolio interview
* these programs required the submission of a mandatory supplementary application form. Admission
is by selection and takes into consideration academics and the mandatory supplementary application
form.
** offers to Arts & Science, Bachelor of Health Sciences and Integrated Science programs are not
made until May
IMPORTANT DATES
The on-line registration deadline for high school students through OUAC is mid-January.
Ontario High School Applicants
January – McMaster may make a limited number of select offers of admission
March – Applicants presenting a minimum of 3 final of 6 midterm Grade 12 U/M courses will
be considered for admission on a rolling basis (program requirements must be included)
April – Applicants reviewed again based on second semester mid-term grades
Out of Province Applicants
Applicants assessed for admission as soon as all required documentation is received
Applicants must have completed or be registered in all program-specific requirements
RESIDENCE
Last year housing in campus residences was guaranteed for students who have an entrance average of
81% or better. Also, any out-of-province student receives a spot in residence automatically.
Transfer students from college or university are NOT granted an automatic spot in residence. As a
result, any student, who is not applying directly from high school or CEGEP, will NOT be given
automatic residence.
TRANSFER STUDENTS
Transfer students, from Canadian colleges or universities, as well as American universities, must all
apply to McMaster University through the OUAC website (www.ouac.on.ca). However, the evaluation
of their application is done manually by the Registrar’s Office. That being said, most transfer students
will require a copy their transcripts (from any previous institution, including high school) to be
submitted to McMaster before the Registrar’s Office will be able to offer them admission. The
Registrar’s Office will evaluate the student based on his/her latest academic work, college or
university. The Registrar’s Office will want to see a proof of ability to complete academic work
successfully. There is no average set in stone. Each applicant is evaluated individually.
The Associate Dean of the Faculty of choice will decide of the number of credits/units given to a
transfer student. This decision will only be confirmed once the student has accepted their offer of
admission. The student should be ready to provide the Associate Dean’s office with a written
description of the courses taken at the previous institution. Such descriptions will be used to identify
the type of work done previously. Course calendar excerpts are usually the most accurate.
WHERE TO GO FOR HELP
The Athlete Services Coordinator is the point of contact for recruiting inquires in the Department of
Athletics and Recreation. They focus on the following areas:
Contact various faculty officers
Verification of admission standards
Confirmation of important dates
Communication with all coaches
Verification of student-athlete status
Contact with student recruitment office
Please note that A&R full-time coaches and coordinators should not conduct tours for recruits. The
Athlete Services Coordinator can help facilitate such tours with tour guides form the Student
Recruitment Office.
4 STEP RECURITING PROCESS
1. IDENTIFICATION – Evaluate the athletic talent as it relates to your sport
2. QUALIFIATION – Evaluate and rate the student-athlete based on previous academic
performance, on the character of the individual and on the needs of your team.
3. SELECTION – Based on the criteria in step 2, rate and rank the prospective student-athletes
and determine how many of them you think are Marauder material
4. RECRUITMENT – Only recruit the student-athletes you have selected. Spend time, energy
and money on students who will help your team.
STUDENT FINANCIAL AID AND SCHOLARSHIP
BURSARIES
McMaster provides bursary assistance to students who demonstrate financial need. A
bursary is a non-repayable grant, not a loan. Bursary funds are intended to assist with a
student's education related costs. To be considered for a bursary, students must be fully
registered at the time of application/payment and have submitted a complete bursary
application by the published deadline.
September 15 is the date that bursary applications became available through the Financial
Aid & Scholarship Office (GH 120). All information can be found following the link:
http://sfas.mcmaster.ca/bursary/macbur.html
ON-LINE APPLICATION TIMELINES
(For Graduate & Undergraduate Students)
All Term 1 & 3 students – September 15th, 2013 to January 10th, 2014
The McMaster Bursary application is available on MUGSI. Find the application on MUGSI by
clicking the “Financial Aid & Scholarships” link and then select “Bursary Application Form”.
Students who receive out-of-province student aid or are not in receipt of government
student aid will be directed to a pdf paper application form. Students who have applied for
OSAP will be prompted to complete and submit their application online.
Bursary payments to eligible students will be made mid-February 2014.
SCHOLARSHIPS WHICH REQUIRE AN APPLICATION
Dr. Ronald V. Joyce Awards (value $2,500)
Current CIS student-athletes (Level I and above) who are returning in September
the following year are eligible
Requires a minimum cumulative grade point average of 8.0 and no failures
For more information and application details, please visit: http://sfas.mcmaster.ca/
DEADLINE IS APRIL 15, 2014.
ATHLETIC FINANCIAL AWARDS
McMaster's Department of Athletics and Recreation supports merit-based athletic financial
awards. With the assistance of Student Financial Aid and Scholarship, a process has been
developed that allows consultation from coaches in designated sports to recommend
identified individuals for financial support to the Athletic Awards Committee. It is the goal of
McMaster University to assist in lessening the financial burden of our leading student-
athletes within the policies laid out by Canadian Interuniversity Sport (CIS) and Ontario
University Athletics (OUA).
In addition, future opportunities will be made available to all student-athletes of McMaster
University to potentially receive an athletic financial award, based on academic and athletic
performance.
For more information, please contact Claire Arsenault, Athlete Services Coordinator, at
[email protected] or 905-525-9140 x23628.
MCMASTER UNIVERSITY
DEPARTMENT OF ATHLETICS & RECREATION
GROUP TRANSPORTATION POLICIES AND PROCEDURES
All students must travel as a part of the group contingent. This includes traveling to the destination site and
returning to McMaster University. The Trip Leader must approve individual exceptions and the student must sign the Independent Travel Assumption of Risk and Release of Liability Form before travel takes place. Any
exception to the University’s travel policy must be approved by the Director of Athletics & Recreation, or designate (Program Coordinator).
CHARTERED VEHICLES
Groups of 21 or more are required to take a chartered vehicle as their mode of transportation
Generally, for drivers of less than 1.5 hours, school buses will be used, unless a group requires luggage
space (e.g. football team). For drivers of longer than 1.5 hours, a 47/55/56 passenger coach will be
arranged. Where possible, groups traveling to the same destination will share a single bus (either a school bus or
chartered bus depending on the length of the trip).
RENTAL VEHICLES
Groups of less than 21 are permitted to rent a vehicle to suit their group’s needs. This rental is done
through the Department of Athletics & Recreation’s preferred suppliers.
All drivers of rented vehicles must be a minimum age of 21 or the required age of the rental supplier.
In addition, all drivers must have a valid domestic driver's license and have at least two (2) years of driving experience in Canada or the United States and complete the Driver History Questionnaire,
and the Travel Intinerary and Travel Roster prior to departure. Only properly authorized employees, volunteers or students may operate University rented vehicles.
Non-authorized use of University rented vehicles is prohibited.
Only members of the official travel contingent may travel with the group.
The number of passengers permitted may not exceed the number of seat belts or the maximum
number of passengers allowed for the driver’s license class.
Drivers and all passengers are required to wear seat belts
The driver assumes full responsibility for any fines resulting from traffic or parking violations arising out
of the use of a University rented vehicle. The vehicle ignition must be off and the vehicle locked when unattended.
Driving is not permitted while under the influence of alcohol or drugs.
Report any accidents or damage while driving a rented vehicle to your supervisor immediately and
follow the rental car procedures.
It is recommended that when there is a group of two or more vehicles leaving a common site at the
same time, those vehicles will travel together to the destination in order to provide assistance, if
needed, and safety for the group. Each vehicle is required to have a cell phone, in case of emergency.
15 PASSENGER VANS – No more than 10 passengers are allowed to travel in one 15-passenger van.
The driver requires a full license, not a graduated license.
PERSONALLY OWNED VEHICLES
It is preferred that all student groups use chartered or rented vehicles for University travel. However,
the Department of Athletics and Recreation recognizes the variety of circumstances and factors that allow for groups to use their personally owned vehicles.
Groups are permitted to use personally owned vehicles for their transportation needs as long as the
destination does not exceed 270 km from McMaster University
All drivers of personally owned vehicles must be a minimum age of 21, or at the discretion of the
program’s travel coordinator. In addition, all drivers must have a valid domestic driver's license and have at least two (2) years of driving experience in Canada or the United States and complete the
Driver History Questionnaire and Travel Intinerary and Travel Roster, prior to departure.
Both the “Driver History Questionnaire” and the “Travel Intinerary and Travel Roster” must
be completed and submitted to the travel coordinator three (3) days prior to departure.
Students who use their personally owned vehicle for travel under University sanctioned events, assume
primary liability should an accident occur. In such cases, the insurance carrier of the individual driving is the primary coverage.
Only members of the official travel contingent may travel with the group.
The number of passengers permitted may not exceed the number of seat belts or the maximum
number of passengers allowed for the driver’s license class. Drivers and all passengers are required to wear seat belts.
The driver assumes full responsibility for any fines resulting from traffic or parking violations arising out
of the use of a University rented vehicle.
Driving is not permitted while under the influence of alcohol or drugs.
Report any accidents or damage while driving a rented vehicle to your supervisor
immediately. When there is a group of two or more vehicles leaving a common site at the same time, those vehicles
will travel together to the destination in order to provide assistance, if needed, and safety for the group.
Each vehicle is required to have a cell phone, in case of emergency.
Both the “Driver History Questionnaire” and the “Travel Intinerary and Travel Roster” must be completed and submitted to the travel coordinator three (3) days prior to departure.
PUBLIC TRANSPORTATION
Public transportation (bus, train, taxi) is permitted to travel to and from University sanctioned events at
the discretion of the Program Coordinator.
DISTANCE DETERMINATOR (Google Maps, 2007)
Algonquin Park 336 km Peterborough 200 km
Buffalo 115 km Quebec City 860 km
Guelph 49 km St. Catharines 67 km
Kingston 327 km Sudbury 435 km
London 126 km Toronto 66 km
Montreal 608 km Waterloo 66 km
North Bay 391 km Windsor 304 km
Ottawa 515 km
MCMASTER UNIVERSITY
DEPARTMENT OF ATHLETICS & RECREATION
VEHICLE DRIVER PRECAUTIONS
Reduce speed below posted limit when roads are wet and slippery.
Use turn signals for every turn or lane change, and double check your blind spot.
Exercise extra caution when backing-up. When possible, have another person act as your guide.
Do a walk-around circle check inspection of the vehicle prior to driving.
Familiarize yourself with the location and operation of controls: lights, wiper/washers, fan heaters, seat
adjustment, check spares and jacks, tires and air pressure.
Adjust the seat to a comfortable driving position and adjust all mirrors for maximum visibility.
Drive defensively:
o Look ahead and recognize possible danger far enough in advance to take preventative action
smoothly o Check mirrors frequently
o Use headlights at all times o Make allowances for the errors of other drivers and pedestrians
o Make allowances for the rapidly changing conditions of the road, weather and traffic
When driving avoid distractions, such as loud music, excessive passenger noise, the use of cell phones
and emotional or distracting conversations
Where possible, having a driving navigator to help keep you awake and focused, and to help with
navigation and passenger comfort.
If you start to become drowsy or feel “highway hypnosis”; do something different immediately: open a
window, talk to someone or just out loud, or adjust your body position. If possible, stop for a rest and
take a short walk or have refreshment or light snack. If you don’t feel more alert, considering finding a
place to sleep for an hour or have another driver take over (if available).
MCMASTER UNIVERSITY
DEPARTMENT OF ATHLETICS & RECREATION
DRIVING HISTORY QUESTIONNIARE
A photocopy of the driver’s license and insurance must accompany this questionnaire.
APPLICANT:
STUDENT #:
PHONE:
EMAIL:
ADDRESS:
1. Do you have a valid Canadian or United States Driver’s License? Yes O No O
2. Please provide the following information:
DRIVER’S LICENSE #:
PROVINCE:
CLASS:
EXPIRY DATE (mm/dd/yr):
3. Is your license now revoked or suspend in Canada Yes O No O
4. Have you driven at least 1,000 miles (1,600 km) in the past three years? Yes O No O
5. Have you been charged with any moving traffic violation or involved in any vehicle accident while driving any
motor vehicle during the last 18 months? Yes O No O
If yes, please specify the following:
Date:
City/Province:
Description:
6. Have you read and do you understand all McMaster University vehicle driver policies, procedures and
precautions? Yes O No O
You are required to notify the Department of Athletics and Recreation supervisor if your license is revoked or suspended for any reason. McMaster University has the legal right to check your driving record with any
government motor vehicle authority.
I certify that all information provided above is correct and true and that I have read, understand and agree to
comply with the Province of Ontario Highway Traffic Act regulations and McMaster University’s Athletic and Recreation vehicle driver policies, procedures and precautions. Any falsification of information or failure to
comply with the mandatory regulations may result in disciplinary and/or removal of driving privileges.
_________________________________________ __________________________ Applicant’s Signature Date
MCMASTER UNIVERSITY
DEPARTMENT OF ATHLETICS & RECREATION
TRAVEL ITINERARY AND TRAVEL ROSTER FOR UNIVERSITY RENTED OR PERSONALLY OWNED VEHICLES
This document is to be submitted to the appropriate Program Coordinator at least 5 WORKING DAYS prior to the trip. In addition, the driver(s) must have completed the DRIVING HISTORY QUESTIONNIARE, including
a photocopy of the driver’s license and insurance.
GROUP NAME: EVENT:
DESTINATION: ACCOMMODATION:
DEPART TIME & DAY:
ARRIVAL TIME & DAY:
TRIP LEADER:
EMERGENCY CONTACT #:
MODE OF TRANSPORTATION: University Rented O Personally Owned O
If personally owned, please fill out the following table:
Owner: Make & Model:
Year: License Plate #: Colour:
Owner: Make & Model:
Year: License Plate #: Colour:
Owner: Make & Model:
Year: License Plate #: Colour:
TRAVEL ROSTER
NAME STUDENT # CELL PHONE # (min. one per car)
DRIVER(S) (please check)
GROUPINGS (list A, B, C by car)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
MCMASTER UNIVERSITY DEPARTMENT OF ATHLETICS & RECREATION
INDEPENDENT TRAVEL ASSUMPTION OF RISK
AND RELEASE OF LIABILITY FORM
NAME:
STUDENT #:
PHONE:
EMAIL:
GROUP/TEAM:
This will serve as confirmation that I will be traveling independently to/from:
LOCATION/EVENT: DATE:
By signing below, I acknowledge the following:
That I declined to use the travel arrangements provided by McMaster University specifically for this
event;
That I will make alternate travel arrangements and accept all risks associated with these arrangements;
That I understand the ramifications of this decision and assume full responsibility for my actions and
well-being while traveling independently: That I am aware of when and where I am to be regarding the above-noted event, and accept the
consequences if I arrive late; and
That I release McMaster University from any and all liability for any loss that occurs as a result of my
decision to make the above-noted independent travel arrangements
Signed this ______________________ day of _______________________, 20__________ (number of day) (month) (year)
___________________________________ ___________________________________
Signature of Student Signature of Trip Leader
MCMASTER UNIVERSITY
DEPARTMENT OF ATHLETICS & RECREATION
STUDENT GROUPS DRIVING PERSONALLY OWNED VEHICLES
In addition, the driver(s) must have completed the DRIVING HISTORY QUESTIONNIARE, including a
photocopy of the driver’s license and insurance.
A student is exposed to the risk of suit for personal liability and/or property damage if he/she chooses to transport other students, athletes or clients of McMaster University to or from University sanctioned events in a
personally owned vehicle.
The University coverage with respect to this area of risk is outlined below. Please check the appropriate circle.
A. If officially asked to drive a personally owned vehicle on behalf of McMaster University. O
The student must provide his/her own damage, collision and liability coverage. In the event of an accident, if his/her liability coverage is inadequate, a university 'excess legal liability coverage' policy may respond. The
vehicle's owner would be responsible for damage and collision coverage.
B. If the student-athlete drives of his/her own accord. O
In the event of an accident, the individual would be considered primarily responsible and his/her own damage, collision and liability insurance would be looked to.
It is the student’s responsibility to ensure that he/she is properly licensed and that he/she carries adequate and
valid damage, collision and liability insurance, when transporting others in a personally owned vehicle.
NAME:
STUDENT #:
PHONE:
EMAIL:
GROUP/TEAM:
DESTINATION/EVENT:
DATE:
I acknowledge receipt of the document entitled "Student-Athletes Driving Personally Owned Vehicles" which briefly describes potential risks, the University's responsibility and my own responsibility in this regard.
I hereby acknowledge that I have read, understand, accept and agree to the risks involved in driving my
personally owned vehicle to or from University sponsored events.
Signed this ______________________ day of _______________________, 20__________ (number of day) (month) (year)
___________________________________ ___________________________________ Signature of Student Signature of Witness
TRAVEL TO THE UNITED STATES
TRAVEL DOCUMENTATION REQUIREMENTS
AIR TRAVEL
Since January 23, 2007, the Western Hemisphere Travel Initiative (WHTI) came into effect for air
travel to the United States. The following documents are acceptable:
a passport; or
a NEXUS card when used at a kiosk at designated Canadian airports and at all U.S.
airports when returning to Canada.
LAND AND SEA TRAVEL
As of June 1,st 2009 Canadian citizens are required to present one of the following valid
documents when entering the United States by land or water:
a passport; a NEXUS card; a Free and Secure Trade (FAST) card; an enhanced driver's license
(EDL) or enhanced identification card (EIC) from a province where a U.S.-approved EDL/EIC
program has been implemented; or a current Certificate of Indian Status. SIMPLIFIED PASSPORT RENEWAL PROGRAM (Available as of August 15, 2007)
The simplified program will allow Canadian citizens, who meet certain eligibility criteria, to renew
their passport using a shorter form and without submitting documentary evidence of citizenship,
supplementary identification and a guarantor declaration. Under the renewal program, passport
applicants will only be required to submit the shorter form along with two new photos, the
application fee and their last passport.
Canadians who meet the following eligibility criteria can renew their passport from the new
program:
Residing in Canada at the time they apply
Resided in Canada at the time of their previous application
16 years old or over at the time of their previous application
Present their previous passport:
o Valid for five years
o Issued after January 31, 2002
o Never damaged or reported as lost or stolen
o Issued under their current name.
The new application form is available at all Passport Canada service points and on-line at Passport
Canada's website (www.pptc.gc.ca), and it will be accepted at all of Passport Canada offices, in-
person or via mail.
NEW GUARANTOR POLICY (October 1, 2007)
The new policy will allow most Canadian adult passport holders to act as guarantors.
Under this new policy, to be a guarantor, a passport holder:
Hold a five-year Canadian passport that is valid or has been expired for no more than one
year,
May be a family member,
May reside at the same address as the applicant,
Known the applicant for at least two years, and
Canadian citizen 18 years of age or older and must have been 16 years of age or older
when they applied for their own passport.
Communication with the Media-
The university Senate acknowledges that members of the McMaster community do not
have complete control over the presentation of material sent to media outlets.
However, it is vital that as much care be taken as possible, to distinguish any type of
communication as being the personal or professional views of an individual or group of
individuals within the university and not as an official McMaster position.
The growth of communication outlets, including social media, means that every effort
must be used to avoid any confusion between the stated policies of the University and
the personal or professional views of members of the McMaster community.
The Senate has developed the following guidelines with regard to any communications
with the media. Care should be taken to clearly state that any communication is being
sent as an individual and not as a representative of McMaster University. Any
opinions expressed on all matters, both internal and external, are considered strictly
personal and do not reflect the views of the university.
This is not meant to restrict the academic freedom or freedom of speech of any member
of the university community.
As members of the McMaster Athletics and Recreation staff, you have access to
department resources if you have any questions or concerns, regarding media relations
or communication issues.
For more information, please contact:
Parrish Offer Manager of Marketing, Communications & Sponsorship McMaster University • Department of Athletics & Recreation DBAC W129 • 1280 Main St W. • Hamilton, ON L8S 4L8 905-525-9140 x20333 • Cell: 905-741-7700 • Fax: 905-526-1573
Updated August 12th, 2013
MCMASTER ATHLETICS AND RECREATION Scheduling Meetings and Deadlines
2013 - 2014
December 9th
, 2013
Scheduling Meeting #1
Spring / Summer (camps)
programmes
December 15th
, 2013 1. Spring/ Summer Practice Requests
Submitted
2. All Spring/ Summer programmes
inputted into CLASS
January 15th
, 2014 1. Business Plan Submission Deadline for
2014 – 2015 Season
January 29th
, 2014 Scheduling Meeting #2
Review Draft of Fall Schedules
Review Business Plan
Submissions
Master Schedule Draft #1 to
follow
February 14th
, 2014 1. Review and Approval of Business Plans
March 3rd
, 2014 1. Confirmation of Business Plan
Approvals
March 25th
, 2014 Scheduling Meeting #3
Review Varsity Practice
Schedules for 14/15 Season
Fall Exhibition schedule dates
Master Schedule #2 to follow
April 30th
, 2014 Scheduling Meeting #4
Review all Varsity Schedules
Confirm Varsity Practice
Schedules for 14/15 Season
Master Schedule #3 to follow
May 19th
, 2014 Scheduling Meeting #5
Discuss any items arising from
OUA Meetings
Prepare for OUA June 1
Deadline
Winter Non-
Conference/tournament schedule
confirmed
Final Varsity game schedules
confirmed
Recreation Schedule
(preliminary) reviewed
June 1st, 2014
1. OUA SCHEDULES DEADLINE
2. All varsity practice and game schedules
inputted into CLASS
June 16th
, 2014
1. All Special Events (university
administered in A&R facilities) inputted into
CLASS
July 5th
, 2014 1. Scheduling Meetings and Deadlines
Schedule for 2014 – 2015 issued.
July 15th
, 2014
1. All instructional, intramural and drop in
programmes inputted into CLASS
August 1st, 2014
1. All non-competitive club practice and
games inputted into CLASS
FACILITY BOOKING POLICY – VARSITY TEAMS
Purpose: To provide fair and equitable use of facilities in accordance with Department and
University policies.
Scope: Facilities are inclusive of all space within the Ivor Wynne Centre; the David Braley
Athletic Centre; Ron Joyce Stadium; Track and Field; the Alumni Field; all fields in the
ten acre area; and the baseball diamonds in west campus.
The scheduling of these facilities occurs generally within two time frames. That is; “in-
season” approximately September 1st to April 30 and “out-of-season”.
Each sport will have their own “in season” and it is only during this time frame
that priority use of facilities will be considered.
Procedures: Coaches will request Varsity practice and games (both Conference and non-
Conference) through their coordinator, who in turn will take the request to
the Scheduling Committee for review.
Please see attached sheet for Scheduling Meetings and Deadlines for the 2013 –
2014 Season. Requests that are provided after the deadline dates will be reviewed
on a one by one basis, but will forfeit any facility priority.
Other Varsity Requests a) Instructional rooms, gyms, fields, etc. – Mark Alfano – [email protected] and
your Athletic Program coordinator
b) The Pulse Fitness Centre – Laura Rietmuller - [email protected]
c) High Performance Centre – Steve Lidstone - [email protected]
d) One Time Request of Fields / Track/ Gymnasiums/ classrooms - email
[email protected] or [email protected] and your Athletic Program Coordinator
e) Facilities (i.e. gyms, Play fields) for special events or tournaments that have not had
business plan submission/ approval - e-mail respective Athletic Program Coordinator
who will in turn, request through the proper channels
Business Plan: Please work with your Athletic Program Coordinator to complete the Varsity
Business Plan (updated version of the business plan is available). The Business Plan
must be submitted for any tournament, camp, and clinic or extended booking of A&R
facilities. Business Plan submission dates are included on the Scheduling Meetings and
Deadlines Outline.
N.B. Throughout the year it may be necessary to alter a team’s practice schedule to
accommodate University activities or other Department events, including tournaments.
The Department of Athletics & Recreation will do its best to provide alternative practice
locations or times where possible.
When organizing tournaments (excluding OUA/CIS), please be aware that a “window”
should be scheduled in to allow for other varsity teams, in season, to have sufficient
practice time.
FINANCIAL PROCEDURES
Each team is responsible to appoint a financial representative- Coach or Manager.
Throughout the season, each representative is responsible for being the liaison
between his/her team and the Athletic Office, Nicole Grosel, Room W109.
1 Cash Advance Required Form for team meal allowance, etc. will be completed,
by the sport co-ordinator and submitted by the end of August. NO CHANGE in
amount requested will be accepted less than 3 weeks prior to the event. If the
above timelines are not met, the co-ordinators will be required to use their
corporate cards, or other means to advance funds. Compliance to the above is
necessary as cash advances are a very time consuming task.
2 Prearranged cash advacnes should be picked up before noon on the day before
travel. If other arrangments are required, please contact Nicole Grosel at least a
week in advance.
3 Meals with Receipt – “Itemized” restaurant receipt is required along with the
credit card slip. The University accepts no other variation. Do not tip over 15% of
the bill before taxes. A list of attendancees is required with each receipt.
4 Any travel per diems must be detailed on a per diem form and signed by each
althete. The department pays $15/day/athlete ($3 breakfast, $5lunch, $7 dinner)
and $20/day/coach ($4 breakfast, $6 lunch, $10 dinner).
5 If expenses exceed the cash advance received, see Nicole for further direction and
forms. A cheque may be given out to reimburse the difference. Please be aware
that this process may take up to a month.
6 Financial reporting of advance money must be made NO LATER THAN
4:30PM ON THE MONDAY FOLLOWING THE COMPETITION AND
RETURNED DIRECTLY TO YOUR ATHLETIC COORDINATOR FOR
APPROVAL. All reqcipts and boarding passes must be submitted at this time.
Please note that boarding passes must be collected for each traveller/each
direction as per university requirments.
7 NO FURTHER MONEY WILL BE ISSUED UNTIL FULL REPORTS
HAVE BEEN SUBMITTED.
CASH CONTROL PROTOCOL
___________________________________________
Whenever possible, all financial transactions should be completed using CLASS in
advance of the date of the event. This would include all registrations for camps, clinics,
tournaments, and purchases of memberships, clothing, etc. Please contact the Business
Office to have the event added to the system – DBAC WG101, ext. 24464.
If the advance set-up cannot be made (example: individuals paying for an event at a time
when there is no access to the Business Office) the following procedures MUST be
implemented.
1. Prior to the event, the designate will pick up a package from the Business Office
which will include the following:
i. Receipt book
ii. Cash bag
iii. Depository key
Instructions for the use of all of the above will accompany the package.
2. Receipt of cash (including cheques and money orders) must be handled in a
formalized, business-like manner, with an appropriate number of people
specifically assigned with the responsibility of registering people and handling
cash.
3. Numbered receipts are to be issued for each payment received. Please note that
these receipts are not donation receipts.
4. When the event is complete, all payments collected and receipt books containing
at least one copy of each receipt are to be deposited using the cash bag
immediately in the after hours depository located outside DBAC W184. Please
refer to the Cash Handling Procedures for details. Please ensure that the funds
deposit balance to the receipts issued.
5. The deposit will be collected from the depository the first working day following
the event and deposited in the appropriate account.
NOTE: Cash received for events is not to be used for event management. Any
cash required for incidental expenses must be requested in writing as
a cash advance, 2 weeks prior to the event, or reimbursed following
the event.
CASH HANDLING PROCEDURES
___________________________________________
Whenever possible, all cash should flow through the Business Office and CLASS which
will issue a formal receipt and be applied to the appropriate account.
In the case that the Business Office is inaccessible the following cash-handling
procedures MUST be implemented.
CHEQUES
Take the time to check the body of the cheque to ensure that all information
is complete and correct (i.e. amount, date, event etc).
All cheques are to be made payable to “McMaster University”.
Record receipt number on back of cheque (required for tracing of NSF
cheques).
No post-dated cheques are to be accepted.
CASH
Cash received for events may NOT be used to cover event expenses.
Any cash required for incidental expenses must be requested in writing
as a cash advance, 2 weeks prior to the event, or reimbursed following
the event.
RECEIPTS
A receipt is to be given for ALL payments received.
The customer receives a white copy, a copy is retained for your records and
the third copy remains in the receipt book.
Record the receipt number on the back of the cheque and on the event form
(if applicable).
Note: all of the following on receipt
o Team
o Form of payment (i.e. cash, cheque)
o Specific purpose of payment (to determine allocation and tax status)
BALANCES
Ensure the funds collected balance to the receipts issued.
One copy of each receipt must be submitted with deposit.
McMaster University
Department of Athletics and Recreation
Gift Certificate Protocol
Background:
In light of the significant requests from the department for prizes, awards, gifts, charities
and camps, for both on and off campus groups, we are establishing a department budget
line. Once the budget is used up for the year, only special requests will be considered.
Procedure:
Please note the following procedure for Gift Certificate requests:
1. All requests for prizes, etc. must be made by email at least five days in advance.
Please email Karen Arnott at [email protected], and CC your department
manager.
2. All prizes will be in the format of a gift certificate from the Maroon Shop/The
Campus Store. (NOT pulse membership or camp registration, etc). The gift
certificates will be eligible for purchases of clothing, giftware, and stationary
products in the Maroon Shop or The Campus Store.
3. Gift certificates in the amount of $25 will be available.
4. The request must have the event/program name and date.
5. All requests must be approved by a department manager
6. Karen Arnott will arrange for the gift certificates.
7. The cost of the gift certificate will be charged directly to the appropriate account.
Room WB 127 – David Braley Athletic Centre 1280 Main Street West, Hamilton, Ontario L8S 4K1 Wheelchair Accessible
Department of Athletics & Recreation, McMaster University Tel (905) 525 9140 ext. 23575 Fax (905) 526-7397
http://www.marauders.ca
2013-2014 Coaches Manual – Sport Medicine Section
1) Student Athlete Medical Screening Process 2) Coverage for Treatment at the Clinic 3) Medical Clearance After Injury 4) Injury and Incident Reports 5) Emergency Care Locations 6) Student Wellness Centre 7) ImPACT Concussion Testing Services 8) Information on Student-Therapists and Hydrotherapy Room Protocol 9) Infectious Disease Protocol 10) Student Therapist contract 11) Private Health Information Form 12) Brochures
STUDENT-ATHLETE MEDICAL SCREENING
• All McMaster student-athletes are required to be medically cleared before they are considered eligible to participate and/or compete. • Completed forms are to be returned to the David Braley Sport Medicine & Rehabilitation Centre 5 BUSINESS DAYS prior to the start of try-outs/training camp for review and approval in order to be cleared. Incoming Student-Athletes:
Those competing in any of the following sports (including invited participants) BASKETBALL, CHEERLEADING, FOOTBALL, HOCKEY, LACROSSE, SOCCER, RUGBY AND WRESTLING are required to have a full medical examination conducted by a physician prior to training camp.
The “Physician Medical Examination Form” is available as a PDF to the students on MARS and is to be printed off and brought to their medical examination. This examination should be completed at least 5 DAYS PRIOR to the start of try-out/training camp as it is a REQUIREMENT FOR PARTICIPATION in try-outs/training camp.
Physical examinations can be done by their own family physician prior to arriving on campus. Physicals can also be done by a physician at the David Braley Sport Medicine & Rehabilitation Centre physicians at a cost of $100. To arrange an appointment, they are to call the clinic at 905-525-9140 x23575.
In the event that a walk-on participant secures a spot on the team’s roster, a full physical examination is required within 3 business days of final team selection. New student-athletes not competing in the aforementioned sports are strongly encouraged
to have a physical medical examination although it is not mandatory.
All McMaster Student-Athletes (Incoming and Returning):
Must complete the “Medical Screening” form available on MARS in its entirety
PRIOR TO THE START OF TRAINING CAMP and must be medically cleared by the
medical staff at the David Braley Sport Medicine & Rehabilitation Centre before they
are considered eligible to participate in try-outs/training camp.
Completed forms are to be returned to the David Braley Sport Medicine &
Rehabilitation Centre 5 BUSINESS DAYS prior to the start of try-outs/training camp
for review and approval.
COVERAGE FOR TREATMENT AT THE DAVID BRALEY SPORT MEDICINE AND REHABILITATION CENTRE
The David Braley Sport Medicine and Rehabilitation Centre collects only the amount covered under the MSU plan & the student athletes’ private insurance. The clinic is committed to providing the best care possible for student athletes and will continue to absorb the cost of treatment for athletes once all insurance coverage is exhausted. For this reason student athletes are not permitted to OPT OUT of the McMaster University Health Plan provided by the MSU. This limited insurance covered from the MSU is used as primary coverage. When this coverage runs out the clinic will then submit to the private insurance to help offset the cost of treatment. MSU Healthcare Coverage The coverage provided by the MSU is an Accidental Death & Dismemberment (AD&D) Benefits plan. This means that the athlete is only covered when an acute injury happens after they have started school. Chronic injuries are not covered. For rookies and new recruits, injuries that occur before the coverage begins, such as training camp, will not be covered. For the clinic to submit of behalf of the student, the following items are required…
1. The student MUST see a doctor within 30 days of the injury 2. An SSQ Form (that the front desk will provide) MUST be completed by the student
athlete and the doctor. The student must explain when & how the injury occurred. This is required to determine whether the plan will cover the accident.
If for any reason a varsity athlete cannot see a doctor before their first physio/chiro visit for their injury, they will still be allowed to come in to the clinic for treatment as we will never turn them away. However, the athlete will be required to sign a form stating that they will see doctor at the David Braley Sport Medicine & Rehabilitation Centre within 1 week. Failure to do so, will result in the student paying for any treatments that have/will occur as a result of not meeting the criteria to submit to the AD&D plan. Private Insurance All student athletes with private health insurance are required to submit their private insurance information. There are two forms that may be given to the student. The first is the MCMASTER STUDENT-ATHLETE PRIVATE HEALTH INSURANCE INFORMATION form. This will determine whether they have insurance or not and this form must be completed before training can begin. If they have insurance, the clinic will email out a second form which request more information and explain how we will be processing their claims. For those students, that have not completed the second form, we will send out a package to each team with the forms that must be completed. These forms will have to be delivered back to the clinic.
COVERAGE FOR TREATMENT AT THE DAVID BRALEY SPORT MEDICINE AND REHABILITATION CENTRE (CONTINUED)
For private healthcare coverage, there are 3 categories of receiving payment for treatments.
1. Online Billing – For Sunlife, Great West Life, Green Shield & Blue Cross we can bill online. The student has the plan holder complete a release form stating that our clinic can bill electronically and receive payment directly.
2. Send invoice to home – For Manulife, the payment is made directly to the plan holder. The clinic will send an invoice to the home for the services provided, the plan holder will complete the required claim form and submit them. Payment must be made to the clinic within 45 days of the invoices being mailed. If the plan has been exhausted for the year, they must bring a statement showing this and the clinic will absorb the cost of the treatments.
3. All other insurance companies require the treatments to be paid in full to be reimbursed. The student athlete will pay for the treatment and receive the invoice and submit to their insurance and be reimbursed directly. If they have exhausted their coverage, they can bring in their statement showing this and the clinic will refund them their money and absorb the cost.
All club athletes will be required to pay for services in the clinic on a fee for service basis, where they will be required to pay up front for treatment and can then be reimbursed by either their private insurance plan or the MSU plan. Their cost of treatment will no longer be absorbed by the clinic. For more information about the MSU AD&D plan, please refer to https://www.msumcmaster.ca/services-directory/36-health-and-dental-insurance/accident-benefits
Medical Clearance After Injury
The following page describes the procedure an athlete must follow if he or she is injured during the course of the season. This clearance should not be confused with the Initial Eligibility Clearance completed at the beginning of each season.
1. When injured, an athlete should immediately notify their coach and student
therapist.
2. Each new injury necessitates medical attention. The athlete MUST make an
appointment with one of the physicians at the Sports Medicine Clinic within 30 days
of the injury
3. The physician will evaluate the injury, recommend a course of treatment, and decide
whether or not the athlete can continue to practice and compete. The physician may
decide to impose restrictions on activity, such as practice with no contact.
4. The physician will fill out a Physician Clearance Form noting whether or not the
athlete can practice or compete, and what restrictions must be followed. The athlete
is also required to sign this form, to acknowledge the restrictions. The physician
will instruct the athlete how and when to follow up on the injury to be cleared.
5. The Physician Clearance Form will be copied for the athlete’s medical file. A copy
will be given to the athlete to give to his or her trainer or coach.
6. The athlete should follow up as instructed by the physician.
7. When the athlete is cleared to play or compete (or restrictions are changed), the
therapist and physician will complete a new form, which will also be signed by the
athlete, kept on file, and given to the athlete to circulate to the trainer and coach.
INCIDENT & INJURY REPORT
- When injuries occur at McMaster, your student therapist will be responsible for filling out the incident and injury report – they will file it at the Sport Medicine Clinic and ensure proper follow up is being done
- When opposing team members are seriously hurt on our home field, it is common courtesy for BOTH the therapist and the McMaster coach to call to follow up. This can be done by calling the opposing coach or their therapist. Student therapists exchange their contact information prior to all games
- If EFERT is involved in assessment or treatment of the injury while competing at McMaster, they will be responsible for filling the incident and injury report.
- The joint health and safety committee monitors all injuries and reports are tabulated monthly for statistical and liability purposes.
http://www.workingatmcmaster.ca/med/document/InjuryIncident-Report-
(Fillable)-1-36.pdf
ImPACT Concussion Testing Services What is ImPACT?
ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is a 20-minute computerized neurocogntive test that can aid in the comprehensive clinical management of concussions for athletes of all ages.
ImPACT testing can be used to assess the mental functioning of an athlete after he or
she has sustained a concussion. A baseline ImPACT test is completed before the athlete’s season begins. It measures the athlete’s concentration, memory, and reflexes when the athlete is not suffering from a concussion. This initial test is known as a baseline test because it shows how the individual athlete functions normally. If the athlete sustains a concussion over the course of the season, he or she will be assessed by a doctor. When the athlete has recovered from the concussion and is feeling better, he or she will complete the ImPACT test again. A doctor can use the comparison between a baseline (normal) test with the test done after the concussion to help determine if the athlete has fully recovered from the concussion. About the ImPACT test
The ImPACT test consists of three categories: demographics, concussion symptoms and neurocognitive tests. These neurocognitive tests are further broken down into six modules that yield 5 composite scores evaluating verbal memory, visual memory, visual motor speed, reaction time and impulse control. The program also includes an evaluation of concussion related symptoms as well as a cognitive efficiency index (CEI) score. ImPACT is a tool that health care professionals may use in addition to clinical assessments to create a multifaceted approach to treating concussions. ImPACT Testing at McMaster:
ImPACT testing is provided through the David Braley Sport Medicine and Rehabilitation Center for individuals of all ages. To book an ImPACT test please call: 905-525-9140 ext 23575.
- A brief introduction and tour of the Sport Medicine Centre - The baseline ImPACT test will be administered to the individual in a supervised
classroom setting - A brief educational video will be provided prior to baseline testing
Should an individual suffer a concussion within the year, a consult appointment should be made immediately to see a Sport Medicine Physician within the clinic and a follow-up ImPACT test will be administrated at a time deemed appropriate by the physician *Baseline testing should be repeated before every season to ensure a valid and accurate baseline If you are visiting campus for the first time log on to: www.mcmaster.ca/welcome/findus.cfm for detailed directions
PROTOCOL FOR HYDROTHERAPY ROOM
There are three areas within the Sports Medicine Department that offer
hydrotherapy: the Ivor Wynne Centre, Ron Joyce Stadium Clinic and the David
Braley Sports Medicine and Rehabilitation Centre.
Protocol:
Ivor Wynne Centre (IWC)
The hydrotherapy room is available for use during regular operating hours of the IWC.
The room will be locked – a key must be signed out at the wicket by the student therapist working with the varsity athletes for respective varsity teams.
The clinic will provide the wicket with a list of student therapists – staff will check the name of student therapist with student ID and the student therapist will be required to sign a log book (time in/time out).
Ron Joyce Stadium Clinic (RJSC)
Hydrotherapy pool use in the RJSC is by approval only. Permission and access shall be granted by the Clinical Supervisor or treating Physio/Athletic Therapist.
A Student Therapist or Student Strength Coach shall supervise use of tubs.
David Braley Sports Medicine and Rehabilitation Centre (DBSMRC) Use of the Sports Med Clinic hydrotherapy Room is restricted to those athletes
receiving treatment in the clinic. Availability is by appointment during business hours.
Guidelines Varsity athletes and student therapists will be required to keep the room clean and
tidy and are asked to drain and clean the tubs after the last use everyday. Tubs are to be used for hydrotherapy of extremities only – total submergence is
NOT permitted. Shorts or bathing suits must be worn. For the safety of yourself and others, athletes with open cuts/sores or any other
communicable disease will not be allowed in the tubs. Cold tub temperature should be in the range of 50 – 55 degrees F. Hot tub temperature should be in the range of 95 – 100 degrees F. Athletes with open cuts/sores/blisters/turf burns/matt burns or any other
communicable disease will not be permitted in the tubs.
INFECTIOUS DISEASE PROTOCOL - SKIN DISORDERS Purpose: To provide a procedure for our athletes, faculty and staff, clients and community members to follow to prevent them from exposure to infectious diseases. Scope: All students, faculty, staff, volunteers and community users. Related Documents: (Public Health/Other)
Impetigo Document – Public Health Definitions: Herpes Gladiatorium: is a cutaneous infection caused by the herpes simplex virus type 1 (HSV-1). It is spread by direct skin-to-skin contact in contact sports, such as wrestling and rugby. Common sites for infection include head, upper extremities, and trunk. Impetigo: is a highly contagious bacterial inflammation of the skin caused by streptococcus (strep) and staphyloccus (staph) bacteria. The infections can be transmitted by direct contact or through sharing towels, clothing and equipment. Lack of personal hygiene, including inadequate cleaning of clothing and equipment, also can aid in the spread of this condition. Tinea Corporis (Ringworm): is caused by dermatophytes, usually of the genus Trichophyton. The condition is a fungal infection. Responsibilities:
Role of Athlete or Individual
Client shall: Ensure that they do not leave any suspicious looking skin condition/rash left
unattended to Responsibility or client/athlete to seek medical attention for skin disorder
for an accurate diagnosis. Must follow the set guidelines/policy regarding appropriate treatment of
condition (ie, meds, covering infected area, etc) incubation period, time away from competition and clinic etc.
Must communicate this diagnosis with coach and rep from the clinic. Hand in documentation of condition “in writing” to clinic –in order to be clear
to return for treatment. Role of Coach Coach shall: (*high priority contact sports esp.wrestling/rugby)
Play close attention to their athlete’s skin conditions. Regular skin checks.
If notice anything suspicious, require athlete to seek medical diagnosis (at the Sports Medicine Clinic) before allowing them to practices or compete.
Require clearance in writing from physician prior to return to play. Must notify clinic as soon as possible of any individuals on the “active list”:
indicate expected timelines. Wherever possible – ensure practice facility has been properly
cleaned/disinfected.
Role of Sport Medicine Clinic
Sport Medicine Staff shall: Ensure a clinic policy is established and enforced with due diligence. Ongoing communication with athletes, coaches and therapists to ensure
procedures are followed. Notify athlete and clinic manager if a suspicious condition is identified and
ensure client follows up with physician (at Sports Medicine Clinic). Ensure all clinic equipment, plinths, mats, etc are properly cleaned and
disinfected. Ensure all staff are washing hands after every patient and wearing gloves
with high risk clients. Daily check of e-mail “active” list of athletes with active disease.
Procedures:
Cleaning procedures: Practice/competition area Clinic Other (pulse, aerobic gym, etc.)
Precautions: Gloves – high risk clients Separate area for high risk clients Hand washing Anything suspicious - send client for medical clearance Ensure documentation of all incidents If a client is infected – they must be properly treated and remain out of
clinic/practice for the appropriate time period. Communication/Records:
All incidents must be documented in client’s chart and incident report Therapist must communicate conclusion to appropriate coach with
guidelines to practice Written documentation of diagnosis, course of treatment, time off
competition, other is required from physician
Student Therapists The Sports Medicine Team has a group of student therapists comprised of McMaster University Kinesiology and Physiotherapy students. All student-therapists were interviewed in the spring and a team of approximately 70 students were selected. All students undergo an extensive, practical training process which compliments their undergraduate studies at McMaster. Students have been assigned teams and this assignment is based on both the student’s skill level and the needs of the team. Most students are working on a volunteer basis and as such, we ask that the coaches treat the student-therapists as part of the team. As the student is attending school full time, as well as completing hundreds of hours with their team over the course of the season, they will only be responsible for sanctioned varsity events (including practices, games, and tournaments). If you wish a student therapist in attendance at a club or a high school event, you must make the request to the David Braley Sport Medicine and Rehabilitation Centre and an honorarium is to be paid to the student from the team’s budget. This point is extremely important as our students’ time is already at a premium. We ask that you please allow time at your initial team meeting for the student-therapist to introduce themselves to the team and explain their role. At this time, the student-therapists will discuss the medical screening process and the insurance requirements. While students are not expected to pay for physiotherapy out of pocket, we need to have the insurance information provided to us in order to continue benefits on the MSU plan. (See attached letter from MSU). The student therapists are expected to be responsible for the care and treatment of your athletes. They are NOT responsible for laundry, balls or any other equipment used by your team. They are not responsible for booking appointments at the clinic for follow up treatment; they only advise and facilitate this process. It is the athlete’s responsibility to book their appointment as only they know their schedules. This helps reduce the likelihood of a no-show fee charged to the athlete. The students should not incur any expenses while working with your team. Their travel costs should be paid for by the team’s budget. If they are required to drive their own car to a game or event, they should be reimbursed for their kilometers. It is expected that the student-therapist is not paying out of pocket for meals while traveling with your team. If your budget does not allow for this, please advise the clinic. The David Braley Sport Medicine and Rehabilitation centre may provide clothing for the student-therapist identifying them as a member if the sport medicine staff. It would be greatly appreciated if you could provide the student with clothing that is ordered for your team as well as a ticket to the year-end athletic banquet. If your team has its own athletic banquet, your student therapist should be treated as part of your team. While the student-therapists are expected to assist with the rehabilitation of injured athletes as part of their learning process, they are not allowed to performed treatment unless they are in the clinic with a supervising therapist. Therapy will be performed during
regular clinic hours only. Your student-therapist will not be expected to treat athletes (other than ice, massage, and stretching) after the clinic is closed.
Coaches should arrange a meeting with their student therapist at the start of the season to discuss expectations, review the varsity schedule and identify potential date conflicts or concerns. We ask that all coaches sign a written commitment with their student therapists, which clearly outlines all travel dates and tournaments that the therapist can expect to attend. This will eliminate any confusion for the student and allows them to plan their school schedule around their travel schedule. (See therapist/coach contract) Please inform your therapist as soon as possible of any changes made to practices or games.
Student Therapist: Coach Contract
Varsity Team: __________________ Head Coach: ______________________ Student Therapist: ______________ Coach’s contact number: ____________ We have reviewed and discussed the upcoming varsity schedule and agree to the outlined travel dates. If there are any changes to this schedule I will ensure that appropriate notice is given and a suitable replacement is found if necessary. It is understood between all parties that I am not permitted to perform treatment unless I am in the clinic or under the direct supervision of a Registered Physiotherapist or Certified Athletic Therapist. After the clinic is closed, it is agreed that I will not treat athletes beyond my scope of practice and training. Please outline any specific needs or expectations that you may have in the space below. Signature of Therapist: _______________________________ Date:_______________ Signature of Coach: ___________________________________ Date:_______________ Signature of Sport Medicine:_________________________ Date:_______________
MCMASTER STUDENT-ATHLETE
PRIVATE HEALTH INSURANCE INFORMATION
Name: _____________________________ Student Number: __________________
Date of Birth: ________________________ Team: ____________________________
Email: _____________________________ Phone: ____________________________
Are you covered under any private health insurance coverage (yours or either/both
parents): YES NO
If YES, please check which companies you have coverage under
Green Shield Canada Manulife Financial
Standard Life Great West Life
Blue Cross Sunlife Financial
Other: ______________________
Do you have any coverage through provincial, national or other teams: YES NO
If YES please state what team: __________________________________
I certify that the information given on this form is true, correct and accurate to the best of
my knowledge
______________________________ ____________________________
Student Signature Date
*** NOTE: AS A VARSITY ATHLETE YOU ARE NOT PERMITTED TO OPT OUT OF THE SCHOOL HEALTH INSURANCE PLAN ***
Room WB 127 – David Braley Athletic Centre 1280 Main Street West, Hamilton, Ontario L8S 4K1 Wheelchair Accessible
Department of Athletics & Recreation, McMaster University Tel (905) 525 9140 ext. 23575 Fax (905) 526-7397
http://www.marauders.ca
Room WB 127 – David Braley Athletic Centre 1280 Main Street West, Hamilton, Ontario L8S 4K1 Wheelchair Accessible
Department of Athletics & Recreation, McMaster University Tel (905) 525 9140 ext. 23575 Fax (905) 526-7397
http://www.marauders.ca
Benefit Assignment Form for Online Billing
Instructions: This form must be filled out when claim payment is assigned to the Provider. Please retain
this form in the patient’s file for verification purposes for two years following closure of the patient file.
Provider: David Braley Sport Medicine &
Rehabilitation Centre
Address: 1280 Main Street West
Hamilton, Ontario L8S 4K1
David Braley Athletic Centre
Room WB 127
Phone: (905) 525-9140 x23575
Patient: ___________________________________
Address: __________________________________
City/Province: ______________________________
Postal Code: _______________________________
Phone Number: _____________________________
Plan Number: _______________________________
Certificate / Plan member Number: ____________
I hereby assign benefits payable for the eligible claims to the Provider responsible for submitting my
claims electronically to the group benefits plan and I authorize the insurer/plan administrator to issue
payment directly to the Provider. In the event my claim(s) are declined by the insurer/plan administrator, I
understand that I remain responsible for payment to the Provider for any services rendered and/ or
supplies provided.
I acknowledge and agree that the insurer/plan administrator is under no obligation to accept this
Assignment, that any benefit payment made in accordance with this Assignment will discharge the
insurer/plan administrator of its obligations with respect to that benefit payment, and that in the event the
benefit payment is made to me, the insurer/plan administrator will also be discharged of its obligation with
respect to that benefit payment.
I understand that this Assignment will apply to all eligible claims submitted electronically by the
Provider and that I may revoke it at any time by providing written notice to the insurer/plan administrator.
If I am a spouse or dependent, I confirm that I am authorized by the plan member to execute an
assignment of benefit payments to the Provider.
_______________________________ __________________________________
Date Plan Holder Signature
Room WB 127 – David Braley Athletic Centre 1280 Main Street West, Hamilton, Ontario L8S 4K1 Wheelchair Accessible
Department of Athletics & Recreation, McMaster University Tel (905) 525 9140 ext. 23575 Fax (905) 526-7397
http://www.marauders.ca
Electronic Transmission Authorization and Consent Form for Online Billing
Instructions: This form must be filled out when claims are submitted electronically by the
provider on the patient’s behalf. Please retain this form in the patient’s file for verification
purposes for two years following closure of the patient file.
Consent to Collect and Exchange Personal Information
Message to the Plan member, Spouse and/or Dependent regarding Personal Information
Personal information that we collect and disclose about you, and if applicable, your spouse
and/or dependents, is used by the insurer and/or plan administrator and their service provider(s) for
the purposes of assessing your claims, underwriting, investigating, auditing and administering the
group benefits plan, including the investigation of fraud and / or plan abuse.
Authorization and Consent
I authorize my healthcare provider to collect, use and disclose personal information concerning
any claims submitted on my behalf with the insurer and/or plan administrator and their service
provider(s) for the above purposes.
I authorize the insurer and / or plan administrator and their service provider(s) to:
use my personal information for the above purposes.
exchange personal information with any individual or organization, including healthcare
professionals, investigative agencies, insurers and reinsurers, and administrators of
government benefits or other benefits programs when relevant for the above purposes.
exchange personal information concerning any claims submitted with the plan member or a
person acting on behalf of the plan member.
exchange personal information for the above purposes electronically or in any other manner.
I understand that personal information may be subject to disclosure to those authorized under
applicable law. I agree that a photocopy or electronic version of this authorization shall be as valid as
the original, and may remain in effect for the continued administration of the group benefits plan.
Room WB 127 – David Braley Athletic Centre 1280 Main Street West, Hamilton, Ontario L8S 4K1 Wheelchair Accessible
Department of Athletics & Recreation, McMaster University Tel (905) 525 9140 ext. 23575 Fax (905) 526-7397
http://www.marauders.ca
Electronic Transmission Authorization and Consent Form for Online Billing
Additional Consent Applicable to Plan Members Only
I confirm that I am authorized by my spouse and/or dependents, if any, to disclose personal
information about them to the insurer and/or plan administrator and their service provider(s) for the
purposes described above and I confirm that my spouse and/or dependents also authorize the
insurer and/or plan administrator and their service provider(s) to disclose information about their
claims to me, for the purposes of assessing and paying a benefit, if any, and managing the group
benefits plan. I also authorize my spouse and/or dependents to assign benefit payments under the
plan to the healthcare provider.
In the event there is suspicion and/or evidence of fraud and/or plan abuse concerning claims
submitted, I acknowledge and agree that the insurer and/or plan administrator and their service
provider(s) may use and disclose relevant personal information to any relevant organization
including law enforcement bodies, regulatory bodies, government organizations, medical suppliers
and other insurers, and where applicable my Plan Sponsor, for the purposes of investigation and
prevention of fraud and/or plan abuse.
If there is an overpayment, I authorize the recovery of the full amount of the overpayment from
any amount payable under the group benefits plan, and the exchange of personal information with
other persons or organizations, including credit agencies and, where applicable, my Plan Sponsor,
for that purpose.
________________________ ___________________________
Date Plan Holder Signature
Store HourStHe BrACING & SPortMeDICINe retAIL Store
Conveniently located in the David Braley Sport Medicine & Rehabilitation Centre
We are a service oriented retail store where our highly trained staff provides valuable assistance with all your sport medicine needs. Our store provides a variety of services including:
OFF THE SHELF BRACING •Ankle•Wrist•Back •Knee•Shoulder•Elbow
CUSTOM BRACING •Ligament•Osteoarthritis
Exercise Aids, Crutches, Cryo Cuffs, Mouthguards, Athletic Tape, and other products.
Other Professional Services provided in The David Braley Sport Medicine & Rehabiltitaion Centre include: •Physiotherapy •AthleticTherapy •Aquatic/Hydrotherapy •Acupuncture •LaserTherapy •MassageTherapy •OsteopathicTechniques •Chiropractic/ART •OrthopedicInjections
In House Consulting Physicians: •OrthopedicSurgeon •SportMedicineSpecialists •Physical Medicine & Rehabilitation Specialist
Monday-Thursday: 8:00 am to 8:00 pm Friday: 8:00 am to 4:00 pm Consultationoutsideclinichoursavailableuponrequest
Located on the McMaster University Campus in the David Braley Athletic Centre WB 127
Contact:Phone: (905) 525-9140 Ext 23575
Fax: (905) 526-7397
Additional information online atwww.athrec.mcmaster.ca/sportmed
AtHLetICS & reCreAtIoN
LoCAteD INtHe DAvID BrALeySPort MeDICINe &
reHABILItAtIoN CeNtre
BrACING & SPort MeDICINe retAIL Store
ServICING your NeeDS CuStoM BrACING ADDItIoNAL SPort MeDICINe SuPPLIeS
off tHe SHeLf BrACING
Our Bracing and Sport Medicine Retail Store offers a full range of services to all of our client populations. Our highly trained staff of health care professionalshavetheexpertiseandskilltomeetall of your individual bracing and sport medicine product needs. We are committed to providing qualityservicebyofferingpremiumsport-specialistendorsed products.
Our health care professionals will assist you in the
selection of a custom functional brace that is best
suitedforyourspecificneeds.Youwillreceiveexpert
adviceontheselection,fittingandproperusageofthe
brace.
Ourqualitybracingandmedicalproducts
willassistyouinaquickreturntoallof
your regular activities!
Ourstore iswellequippedwithavarietyofbracestylesand sizes to best accommodate your individual needs. Our bracing specialist will assist in your selection and en-sureaproperfit.
Treatmentforcommoninjuries: •Sprainedankle •Hypermobilejoints •Groinpulls •Shouldersubluxation/dislocation •Carpaltunnel •Lowback/SIjointpain
•Widevarietyofstylesofcustomligamentorosteoarthritis(OA)kneebraces•Accommodationofindividualbodytypes and varying activity levels•Castingandfittingdoneonlocation•Bracesfromelitevendorswithwarranty•Quickturnaroundtime
•customorthotics•orthopedicsoftgoods•exerciseaids•crutches•cryocuffs•mouthguards•athletictape•coldpacks•compressiongarments
Team Bracing:•Wespecializeinteamfittingsandorderingofprophylacticbracing to reduce taping costs.
•Insurance documents provided to facilitate reimbursement of insurance claim.
ABOVE INFORMATION TO BE USED FOR COMPLETION OF WSIB CLAIM FORM #7 1
PLEASE PROVIDE A COPY TO: Department Chair, Manager or Director Environmental & Occupational Health Support Services Employee/Other HR/Rev Dec 2011 RETURN TO: EOHSS, GH 304 (Fax# 905.540.9085) OR HEALTH SCIENCES SAFETY, HSC 1J11 (Fax# 905.528.8539)
Injury / Incident Report NO INJURY INJURY
INSTRUCTIONS ON PAGE 3 Hazardous Situation First Aid Healthcare Blood/Body Fluid Exposure Lost Time Critical Injury No First Aid
IMPORTANT – IF PERSONAL INJURY IS INVOLVED, FORM MUST BE FAXED WITHIN 24 HRS. OF THE INCIDENT TO EITHER ENVIRONMENTAL & OCCUPATIONAL HEALTH SUPPORT SERVICES (FAX# 905.540.9085, GH 304) OR FACULTY OF HEALTH SCIENCES SAFETY OFFICE (FAX# 905.528.8539, HSC 1J11)
SECTION 1: TO BE COMPLETED BY INDIVIDUAL REPORTING INCIDENT
To b
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by
Indi
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epor
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Inci
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LAST NAME FIRST NAME EMPLOYEE ID/STUDENT ID (if applicable)
DEPARTMENT/UNIT EXTENSION Occupation at the time of injury: _____________________________ Years of service to McMaster in occupation: ____________________
AFFILIATION EMPLOYEE STUDENT OTHER (Please specify): ____________________________________________________________
UNION/EMPLOYEE GROUP CUPE CAW IUOE MUFA TMG SEIU CASUALS MUALA OTHER
DD/MM/YY OF INCIDENT TIME OF DAY AM PM
DD/MM/YY REPORTED TIME OF DAY AM PM
DESCRIPTION OF INCIDENT INCIDENT LOCATION: BLDG. NAME ______________________________________ ROOM # ___________
STATE EXACTLY THE SEQUENCE OF EVENTS LEADING UP TO THE INCIDENT: (1) WHAT WERE YOU DOING AND DESCRIBE THE EFFORT INVOLVED? (2) SIZE, WEIGHT AND TYPE OF EQUIPMENT OR MATERIALS INVOLVED (IF APPLICABLE) (3) WHAT HAPPENED TO CAUSE THE INJURY? (4) WHAT CONDITIONS ATTRIBUTED TO THE INCIDENT/ACCIDENT? (5) HOW COULD THE EVENT HAVE BEEN AVOIDED?
ADDITIONAL INFORMATION ATTACHED NAME AND ADDRESSES OF WITNESSES
AREA OF INJURY (Check all that apply)
EYES HEAD ARMS CHEST INTERNAL BACK HANDS LEGS FEET NECK
DOMINANT HAND LEFT RIGHT
TYPE OF INJURY (Check all that apply)
ABRASION/CONTUSION BURN LOSS OF CONSCIOUSNESS SPRAIN/STRAIN ALLERGIC REACTION CUT/LACERATION MEDICAL SYMPTOMS OTHER _______________________________ ANIMAL/INSECT BITE GRADUAL ONSET PUNCTURE/NEEDLESTICK NAME OF ATTENDING PHYSICIAN (To be completed only if healthcare obtained) __________________________________________________________________
TEL: _____________________ DATE OF HEALTHCARE: ______________________
TREATMENT OF INJURY EMPLOYER PHYSICIAN EMERGENCY NONE FAMILY PHYSICIAN WALK-IN CLINIC OTHER (Please specify) ______________________________
SIGNATURES I certify that the above information is true and complete to the best of my knowledge. PERSON REPORTING INCIDENT (PRINT NAME)
______________________________________
DATED
__________________________
SIGNATURE
___________________________________________________
ABOVE INFORMATION TO BE USED FOR COMPLETION OF WSIB CLAIM FORM #7 2
PLEASE PROVIDE A COPY TO: Department Chair, Manager or Director Environmental & Occupational Health Support Services Employee/Other HR/Rev Dec 2011 RETURN TO: EOHSS, GH 304 (Fax# 905.540.9085) OR HEALTH SCIENCES SAFETY, HSC 1J11 (Fax# 905.528.8539)
SECTION 2: TO BE COMPLETED BY SUPERVISOR
To b
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by
Supe
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or
CONTRIBUTING FACTORS WHAT CONDITIONS CONTRIBUTED TO THE INCIDENT () (Check all that apply).
1 OPERATING WITHOUT AUTHORITY 2 FAILURE TO LOCK OUT 3 INSUFFICIENT TRAINING 4 UNSAFE EQUIPMENT/POOR DESIGN 5 IMPROPER POSITION OR POSTURE 6 FAILURE TO USE PERSONAL PROTECTIVE DEVICES 7 NOT GUARDED OR IMPROPERLY GUARDED 8 INADEQUATE ILLUMINATION 9 FIRE, EXPLOSION HAZARD
10 POOR HOUSKEEPING 11 UNSAFE PRACTICE 12 HAZARDOUS ENVIRONMENTAL CONDITION 13 DISTRACTING, TEASING, WILLFUL MISCONDUCT 14 INCLEMENT WEATHER 15 OTHER (EXPLAIN)
TO YOUR KNOWLEDGE HAS THE EMPLOYEE HAD A PREVIOUS SIMILAR INJURY?
YES NO
IN ADDITION TO THE CHECKLIST, PLEASE DESCRIBE IN DETAIL THE CAUSE(S) OF EVENT – ROOT CAUSES WHICH COULD INCLUDE ANY OR ALL OF THE FOLLOWING: PHYSICAL CAUSES, HUMAN CAUSES, AND ORGANIZATIONAL CAUSES. DETAILS OF PROPERTY DAMAGE (IF APPLICABLE)
CORRECTIVE MEASURES ACTIONS TO PREVENT RECURRENCE () (Check all that apply).
1 REINSTRUCTION OF PERSON INVOLVED 2 REASSIGNMENT OF PERSON 3 ERGONOMIC ASSESSMENT 4 IMPROVED PERSONAL PROTECTIVE EQUIPMENT 5 EQUIPMENT REPAIR OR REPLACEMENT 6 CORRECTION OF CONGESTED AREA 7 INSTALLATION OF GUARD OR SAFETY DEVICE
8 ACTIONS TO IMPROVE WORK PROCEDURE 9 CHECK WITH MANUFACTURER 10 DISCIPLINE OF PERSONS INVOLVED 11 COMMUNICATION TO THE REPONSIBLE PERSON/DEPARTMENT 12 OTHER (EXPLAIN)
IN ADDITION TO THE CHECKLIST, PLEASE DESCRIBE IN DETAIL CORRECTIVE MEASURES TO PREVENT RECURRENCE
PERSON RESPONSIBLE FOR ACTION: COMPLETION DATE:
LOST TIME INCIDENT ONLY
Scheduled Shift on Day of Injury
Date/Time Last Worked
Date/Time Returned to Work Regular Days & Hours of Work: S M T W Th F Sa ___ ___ ___ ___ ___ ___ ___
SIGNATURES I certify that the above information is true and complete to the best of my knowledge. SUPERVISOR / EXTENSION # (PRINT NAME)
______________________________
DATED
________________
SIGNATURE
_______________________________________ DEPARTMENT HEAD (PRINT NAME)
______________________________
DATED
________________
SIGNATURE
_______________________________________
ABOVE INFORMATION TO BE USED FOR COMPLETION OF WSIB CLAIM FORM #7 3
PLEASE PROVIDE A COPY TO: Department Chair, Manager or Director Environmental & Occupational Health Support Services Employee/Other HR/Rev Dec 2011 RETURN TO: EOHSS, GH 304 (Fax# 905.540.9085) OR HEALTH SCIENCES SAFETY, HSC 1J11 (Fax# 905.528.8539)
TYPES OF INCIDENTS TO REPORT HAZARDOUS SITUATION – Refers to an incident caused by an unsafe act, an unsafe condition or a combination of both in the work environment which could have resulted in property loss and/or physical harm. FIRST AID INJURY – An injury of such minor nature that treatment can be carried out by application of a band aid, cold compress or any other content of a first aid kit. HEALTHCARE INJURY – An incident which requires treatment or service rendered by a health care professional but does not result in time lost from work other than the day of injury. LOST TIME INJURY – Refers to an injury which results in time lost from work beyond the day of the injury. BLOOD / BODY FLUID EXPOSURE – Refers to exposure to body fluids with the capability of transmitting disease organisms, i.e. blood, seminal fluid, vaginal secretions, cerebral spinal fluid, synovial fluid, pleural fluid, peritoneal fluid, pericardial fluid, amniotic fluid and tissues.
Critical Injury is defined as an injury of a serious nature that: places life in jeopardy; produces unconsciousness; results in substantial loss of blood; involves the fracture of a leg or arm, but not a finger or toe; involves the amputation of a leg, arm, hand or foot, but not finger or toe; consists of burns to a major portion of the body; or causes the loss of sight in an eye.
In the case of a critical injury, supervisors are responsible for: 1. Securing the accident site and ensure that further injury is prevented. 2. Immediately arranging for medical and emergency assistance by call Security at “88” or “5555” at host hospitals and “911” at any other off-campus locations. 3. Immediately notifying Environmental and Occupational Health Support Services at ext. 24352 and communicate details of the incident. 4. Ensure that the site remains undisturbed until Environmental and Occupational Health Support Services provide clearance. 5. Cooperating with directives from Environmental and Occupational Health Support Services and the Ministry of Labour.
RESPONSIBILITIES Employee Responsibilities 1. Promptly receive appropriate medical treatment. 2. Notify supervisor as soon as possible of injury and any related healthcare. 3. Assist with the completion of Injury/Incident form and sign it. 4. Assist in the incident investigation and implementation of any corrective action. 5. Adhere to the legal requirements of WSIB and participate in McMaster University’s Return to Work Program if modified work and/or lost time results from a work related
injury.
Supervisor Responsibilities 1. Ensure that the injured employee receives appropriate medical treatment in the case of personal injury. 2. Provide transportation for the injured employee to a healthcare practitioner or Emergency and provide a Functional Abilities Form. 3. Report the injury/incident to Environmental and Occupational Health Support Services or the Faculty of Health Sciences Safety Office using the Injury/Incident Form. 4. Investigate the incident as soon as possible and take corrective actions when appropriate to prevent reoccurrence. 5. Inform Environmental and Occupational Health Support Services and Employee Health Services promptly if an employee has been diagnosed with an occupational disease. 6. Inform Employee Health Services at ext. 23564 / 23454 if healthcare was sought and/or employee lost time from work, of any return to work or any change in the
employee’s status. 7. If person responsible for corrective measures/completion date is unknown, the Incident/Injury report is to be submitted with this information to follow when available. 8. If the Supervisor or Department Head is unavailable to sign the injury/incident report, the report should be submitted with all available signatures and resubmitted with
remaining signatures when possible. The information gathered on this form is collected under the authority of the McMaster University Act, 1976. The information is used for the academic, administrative, employment-related, financial and/or statistical purposes of the University including, but not limited to, admissions; registration and maintaining records; awards and scholarships; convocation; provision of student services, including access to information systems; alumni relations; and disclosure to or on the behalf of the applicable McMaster student government. This information is protected and is being collected pursuant to section 39(2) and section 42 of the Freedom of Information and Protection of Privacy Act of Ontario (RSO 1990). Questions regarding the collection or use of this personal information should be directed to the University Secretary, Gilmour Hall, Room 210, McMaster University. In addition to collecting personal information for its own purposes, McMaster University collects specific and limited personal information on behalf of the McMaster Student Union, the McMaster Association of Part-time Students and/or the McMaster Graduate Students Association. The groups use the information for the purpose of membership, administration, elections, annual general meetings, health plans and other related matters only. Please contact the relevant Student Union/Association office if you have questions about this collection, use and disclosure of your personal information.
Instruction for Completing Form The employee has the responsibility of reporting incidents promptly. The employee and the supervisor must fill out the designated portions of this form and the employee, supervisor and department head (chair, director, etc.) must sign it. The supervisor is responsible for investigating the accident and for ensuring corrective action to prevent a recurrence of the incident for due diligence purposes. If personal injury is involved, all appropriate procedures must be followed (please refer to RMM 1000 and 1002). The report must be forwarded immediately to Environmental and Occupational Health Support Services at 905.540.9085, or for areas in the Faculty of Health Sciences, forward to the Safety Office at 905.528.8539. If you require additional assistance, please contact Environmental & Occupational Health Support Services at ext. 24352 or the Health Sciences Safety Office at ext. 24956.
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CounsellingFor common concerns such as
substance use, relationship issues and low self-esteem; mental health support and therapeutic groups.
Medical ServicesFFor assessment and treatment of illness and injury, health check-ups, immunizations and allergy injections, sexual health counselling and testing; specialty health services such as sports medicine, psychiatry and
naturopathic medicine.
WWellness EducationFor workshops, events and resources to help you make better choices for your
health and well-being.
Student Wellness Centre
EMERGENCY CARE LOCATIONS
Driving directions to 690 Main St W, Hamilton, ON L8S 1A4, Canada : URGENT CARE David Braley Athletic Centre
Hamilton, ON L8S 4E8, Canada
1. Head south toward Stearn Dr – 290m
2. Turn left onto Sterling St – 89m
3. Take the 1st right onto Forsyth Ave N – 800m
4. Turn left onto Main St W/County Road 8
Continue to follow Main St W – 1.8km
Destination will be on the left
690 Main St W
Hamilton, ON L8S 1A4 Tel: 905-521-2100 Ext 72000
Driving directions to St Joseph's Healthcare Hamilton Charlton Campus
David Braley Athletic Centre
Hamilton, ON L8S 4E8, Canada
1. Head south toward Stearn Dr – 290m
2. Turn left onto Sterling St – 89m
3. Take the 1st right onto Forsyth Ave N – 800 m
4. Turn left onto Main St W/County Road 8 – 4.2 km
Continue to follow Main St W
5. Turn right onto James St S – 650 m
6. Turn left onto Charlton Ave E – 180 m
Destination will be on the right
St Joseph's Healthcare Hamilton Charlton Campus
50 Charlton Ave E
Hamilton, ON L8N 4A6, Canada Tel: 905-522-4941
Driving directions to Hamilton General Hospital David Braley Athletic Centre
Hamilton, ON L8S 4E8, Canada
1. Head south toward Stearn Dr – 290m
2. Turn left onto Sterling St – 89m
3. Take the 1st right onto Forsyth Ave N – 800m
4. Turn left onto Main St W/County Road 8 – 4.4km
Continue to follow Main St W
5. Turn left onto John St S – 1km
6. Turn right onto Barton St E – 850m
Destination will be on the left
Hamilton General Hospital
237 Barton Street East
Hamilton, ON L8L 2X2, Canada Tel: 905-527-0271
Driving directions to Hamilton Health Sciences - McMaster University Medical Centre, Hamilton, ON L8S 4J9, Canada David Braley Athletic Centre Hamilton, ON L8S 4E8, Canada
1. Head south toward Stearn Dr – 290m
2. Turn left onto Sterling St – 89m
3. Take the 1st right onto Forsyth Ave N – 650m
4. Turn right – 72m
Destination will be on the left
Hamilton Health Sciences - McMaster University Medical Centre
Hamilton, ON L8S 4J9, Canada
McMaster University
Department of Athletics
and Recreation
Emergency Procedures and Safety Guidelines for
Volunteers
2013/2014
Health and Safety
All Department of Athletics and Recreation volunteers and staff members have a role to play in ensuring the safety of participants and visitors. Preventing accidents before they occur is the goal. It is impossible to remove all possibility of an injury occurring. But you can remove the probability of an accident – by anticipating potential dangers; by manipulating the environment so that the danger is minimized; by finding the right balance between safety and fun; by keeping your first aid skills current, ensuring participants are safe and caring for them properly if an emergency occurs. If you are unable to manipulate the environment yourself, it is your responsibility to inform your supervisor of a dangerous situation. In some instances, you may have to make a decision to close an area off or down due to imminent danger.
If you get injured
If you are injured while volunteering, seek assistance from a co-worker for treatment. If necessary, follow up with medical assistance immediately. Your health and safety is our first concern. It is absolutely essential that you report any injuries that occurred to your full time supervisor and fill in the McMaster University Injury/Incident Form. Electronic versions can be found at: http://www.workingatmcmaster.ca/med/document/InjuryIncident-Report-%28Fillable%29-1-36.pdf If you are unable to reach your full time supervisor, you must fill in the McMaster University Injury/Incident Form (located in the appendix) and leave it in your supervisor’s mailbox. Follow up with an e-mail to your supervisor. This is to ensure that follow up procedures outlined in Workplace Safety and Insurance Board legislation are initiated.
Emergency Phone Number: Campus Phone Dial 88
Cell Phone Dial 905-522-4135
DO NOT DIAL 911 Dialing 9-1-1 will delay an ambulance because EMS will call McMaster Security to verify the call. McMaster Security will meet EMS at the McMaster entrance. EMS
relies on McMaster Security to get them to the scene quickly.
Medical Emergencies
If you are volunteering with a team where an athletic therapist is present, they have been trained in these procedures and will lead the
provision of first aid. If they are not available, please follow the following steps.
'Critical Injury' the following steps must be followed:
isor, contact the Environmental and Occupational Health Support Services office at ext. 24352 or by dialing 88 during off hours.
Do Not Alter the Scene!
The Occupational Health and Safety Act requires specific procedures to be followed in the event of a 'Critical Injury'.
A Critical Injury is defined as an injury of serious nature that:
urns to a major portion of the body
In case of a suspected critical injury contact Environmental and Occupational Health Support Services Office at ext. 24352 during regular business hours or ext. 88 during off hours for assistance and clarification.
In the Event of a MILD INJURY or ILLNESS
1. If there is any doubt about the nature or severity of the situation, follow Critical Injury/Illness procedure.
2. If the injury is mild and the victim does not want emergency assistance, call Security at ext. 24281 to request transportation to the hospital.
3. Qualified staff may provide assistance. 4. Fill out a McMaster Injury/Incident Report Note: The David Braley Sport Medicine and Rehabilitation Centre is staffed by a variety of medical professionals that will assist in CRITICAL INJURY or ILLNESS. For basic first aid assistance, and your athletic therapist is not available, please contact the Joan Buddle Service Desk.
Incident/Accident Reports
All accidents, injuries and incidents must be followed-up with a McMaster University Injury/Incident Report. It is essential that all information is complete, and handed in immediately to your supervisor. Bring any incident that requires immediate action to her/his attention.
Use this form for personal injury to a staff member or critical injury to any person.
Use this form for any minor personal injury to any program participant.
Use this form for any incident or misbehaviour that does not involve personal injury. Some examples include fire alarm, criminal activity, and situations of potential personal injury or property damage e.g. unsafe equipment or conditions.
General Emergency Procedures FIRE ALARM
1. Activate nearest fire alarm. Pull stations are located along exit paths. Fire department is automatically dispatched.
2. Close doors. 3. Evacuate building. 4. If possible, call “88” to give location and nature of emergency. 5. If you have information about the emergency, meet the Fire Department at the South
Entrance to the building. 6. Ensure that no one re-enters the building until the Fire Department gives permission.
FIRE WARDENS
Chief Building Fire Warden: Mark Alfano, Manager of Athletics and Events Associate Chief Fire Warden: TJ Kelly, Facility Supervisor Primary Fire Wardens: Debbie Marinoff Shupe, Wayne Terryberry and Joan Buddle Service Desk Staff In the event of a fire, the Chief Building Fire Warden is the report person to ensure the facility is cleared quickly and safely. In his absence, the Associate Chief Fire Warden will assume responsibility. Primary Fire Wardens will be assigned to specific areas in the building and will communicate to the Chief Fire Warden by radio. They will ensure their area is cleared by advising people to leave the building and providing assistance to anyone who requires it, without endangering themselves. The people will collectively evacuate the building in an orderly fashion and provide emergency personnel with pertinent information.
CHEMICAL/ GAS LEAKS
Contact the Joan Buddle Service Desk for assistance. If they are unable to assist follow these procedures:
1. If you detect a peculiar smell but are unsure of the source, contact “88” and request
assistance. 2. Report immediately to your supervisor. 3. Meet emergency personnel and give them information regarding the nature and
location of the leak.
PEOPLE TRAPPED IN AN ELEVATOR
1. Contact the Joan Buddle Service Desk for assistance. If they are unable to assist follow these procedures:
a. Tell the people in the elevator to use the emergency phone to call security. b. Security will dispatch an elevator technician. c. Wait by the elevator for security personnel. d. Ask for information about who is trapped and notify those who might be looking
for them. e. If someone else is available, ask him/her to post “out of order,” signs at the
elevator door on each floor of the building. Please remember to remove these signs once the elevator is serviceable again.
Storm Emergency Procedure McMaster closures will be announced on local radio stations: Y95, 95.3 FM, Oldies 1150 AM, CHAM 820 AM, CHML 900 AM, CBC Radio One, 99.1 FM, CFMU 93.3 FM Your coordinator will provide further information on storm emergencies.
Criminal Emergency Procedures ROBBERY (IN PROGRESS)
1. As soon as it is safe to do so, call “88” to report a robbery. 2. Follow all directions of the burglar without endangering your own life or those of any
others. 3. Do not withhold cash or property. 4. Make observations carefully for the police
THEFT Contact the Joan Buddle Service Desk for assistance. If they are unable to assist follow these procedures:
1. Upon discovery of the theft, call Campus Security at ext. 24281 to describe the situation. 2. Try to identify what is missing without disturbing the scene. 3. Wait for security for further instructions.
ASSAULT/ALTERCATION
1. Immediately call “88” to inform security of the situation. 2. If either party wants to leave the situation, ask them to wait in a protected area. 3. Do not attempt to intervene in the altercation. 4. Ensure the safety of bystanders by clearing the area. 5. Fill out “Occurrence Report”
Blood Exposure Procedures
Contact the Joan Buddle Service Desk for assistance. If they are unable to assist follow these procedures:
1. When informed of a blood exposure, you must attend to the situation only after you put
on non-latex gloves (available in the first aid kit).
2. Disinfect the wound with Salvodil and apply sterile gauze.
3. Remove gloves only after all blood has been cleaned properly. Any used gloves, gauze
pads or other contaminated materials must be placed in plastic Ziploc bags found in
first-aid kits and disposed of in the “Biohazard” containers located in the Service Desk
and the Sport Medicine Clinic. The contaminated bags must not be disposed of in any
other manner.
4. If blood is transferred to the body or clothes of another person, the area must be
disinfected. On skin, use an alcohol swab. On clothing, use bleach/water solution found
at the Service Desk, or in the Sport Medicine Clinic.
5. If blood has been spilled onto the floor or other hard surfaces, close off the area to avoid
spreading the hazard. Use disinfectant spray on the area, allow it to soak for one
minute, then use paper towel to clean the area. Place all materials in plastic Ziploc bags
(see #3). If any type of instrument punctured the skin (e.g. broken glass) it must be
disposed of in the sharps container in the Sport Medicine Clinic. For your own safety,
needles should not be recapped.
6. Any contaminated laundry should be washed in hot water with bleach.
First Aid Kits are located at the Joan Buddle Service Desk in the David Braley Rehabilitation and Sport Medicine Clinic, the pool and the Pulse. Automatic External Defibrillators (5) are located in the Ron Joyce Stadium, pool, outside the Smith Gym – south wall, in front of the Joan Buddle Service Desk and in the David Braley Rehabilitation and Sport Medicine Clinic. Trained AED staff are lifeguards, Joan Buddle Service Desk staff, Pulse trainers, student field therapists and the David Braley Rehabilitation and Sport Medicine Clinic staff.
Emergency Phones
In case of an emergency, dial “88” from a building phone and this will connect you directly to security.
Emergency phones are located throughout the building and surrounding athletic fields. The phones are automatically connected to security.
Emergency Phone Locations
In David Braley Athletic Centre
- 2nd floor of the Pulse - Pool Deck - Women’s Locker Room - Men’s Locker Room - North Side Indoor Track
In Ivor Wynne Centre
- Outside East Auxiliary Gym - Women’s Locker Room - Ticket Booth on 1st floor - North Side Track
Outside the building
- South entrance to track - North end of Alumni Field
Pay Phone Locations
- Across from concession stand on 1st floor – IWC - Beside Maroon Shop - DBAC
COACHES PARKING 2013-2014
Monthly rate lot H $68.00 per month; evening rate $46.00 per month
At beginning of season determine who of your coaching staff should receive
parking & communicate this to Nicole Grosel x24466 or [email protected]
Will need to know name, contact information and length of parking term for each
of your staff requiring parking
Coaches need to fill out a parking application and send it to Nicole to forward to
parking. The form can be downloaded at http://parking.mcmaster.ca/apply.htm
A transponder will be issued in your name (please see instructions in brochure on
how to mount & utilize). They are not transferable to another vehicle, nor should
they be shared. Athletics and Recreation will not pay for fines resulting from
misuse; it will be your responsibility to rectify your own fines.
Journal entries to your account will be made on a monthly basis.
Validation tickets or rebate vouchers for one-time parking allowances (i.e.
recruiting) are issued through Nicole Grosel up to a maximum one time parking
charge of $20 – An account number will need to be provided to charge this to
prior to issuing.
APPAREL AND UNIFORMS 2013-2014
Please contact Nicole Grosel for apparel, and uniform inquiries at x23400 or
through email at [email protected].
QUICK LINKS 2013-2014
ATH & REC http://www.marauders.ca/
ALTITUDE http://www.marauders.ca/index.aspx?path=altitude&tab=altitude
CIS http://www.cis-sic.ca/splash/index
HP TESTING http://www.marauders.ca/sports/2011/3/28/Highperformancetesting.aspx?tab=hptesting&path=strength
M.A.C http://www.marauders.ca/index.aspx?path=mac&tab=mcmasterathletescare
OUA http://oua.ca/
PARKING http://parking.mcmaster.ca/
SPORTS MEDICINE http://www.marauders.ca/index.aspx?path=sportsmed&tab=home2
S&C http://www.marauders.ca/index.aspx?path=strength&tab=home2
Strength and Conditioning Resources Strength & Conditioning Coordinator
Steve Lidstone
905-525-9140 x20365
Sport – Strength & Conditioning Coach Email Address
Men’s Basketball – Josh Ford [email protected]
Women’s Basketball – Josh Ford [email protected]
Football – Scott MacKenzie [email protected]
Men’s Soccer – Tony Giannikouris [email protected]
Women’s Soccer – Tony Giannikouris [email protected]
Men’s Rugby – Tony Giannikouris [email protected]
Women’s Rugby – Tony Giannikouris [email protected]
Men’s Volleyball – Josh Ford [email protected]
Women’s Volleyball – Josh Ford [email protected]
Swimming – Stu Wilson [email protected]
Track – Tony Giannikouris [email protected]
Wrestling – Jamie Cote [email protected]
High Performance Area Hours
Fall Schedule
September 3, 2013 – December 5, 2013
Facility open 7am-11pm Monday – Friday
CIS Open Varsity Hours
Monday, Tuesday, Wednesday, Friday 12:00pm - 3:00pm
Thursday 1:30pm – 3:00pm
Winter Schedule
January 6, 2014 – April 30, 2014
CIS Open Varsity Hours
Monday to Friday 12:00pm - 3:00pm
Summer Schedule
May 1, 2014 – September, 2014
CIS Open Varsity Hours
Monday - Thursday 1:00pm – 9:20pm
Friday 1:00pm – 8:20pm
Saturday 10:00am – 2:00pm
The Bastable Resource Centre is a place of study and educational advancement for McMaster student-athletes. In order to maintain an environment appropriate to our purpose, the following rules and regulations must be followed: USE OF THE RESOURCE CENTRE
1. The Resource Centre is open during regular Athletic facility building hours. Please consult http://www.marauders.ca for hours of operation.
2. Please treat the Resource Centre as a QUIET study area for the benefit of you and other student-athletes.
3. In cases of deliberate and repeated breach of these regulations, the Resource Centre may suspend the privilege of access to the facility.
THEFT, MISAPPROPRIATION OR MUTILATION OF RESOURCE CENTER MATERIALS
4. The University considers theft, misappropriation, mutilation, or tampering with the Resource Centre materials, equipment or property by any user to be a serious offence. Please respect all resources in the Centre.
RESOURCE MATERIAL-Not Returned, Lost or Damaged
5. Please do not abuse the white-boards found in the Resource Centre. Only specific markers are to be used.
STUDY SPACE
6. Individual study space cannot be reserved. Please take books and personal belongings when leaving the Centre.
7. The Group Study room may be booked for such use through Claire Arsenault ([email protected]).
NOISE
8. Conversation should not take place in quiet study areas and other noise should be kept to a minimum.
OTHER
1. Please refrain from using cell phones in the Resource Centre. Student-athletes should turn off or make silent all cell phones and pagers when entering the Resource Room.
2. Lounge chairs and seating should remain in designated areas. Only one lounge chair or seat per person is allowed. Do not put feet on the furniture.
3. Please use the facility during its normal hours of operation. 4. Please leave bikes outside of the Resource Centre. 5. Banners or notices must have the prior permission of the Bastable Resource Centre
administration before being posted on the Resource Center premises. Postings on the bulletin boards require permission from Claire Arsenault ([email protected]).
Many of the rules and regulations were founded from the General Regulations for McMaster University Libraries