Athletic Participation Forms – Academy of the Holy Angels

Section Break

Student Name(Required)

First Last

Sport(Required)

Date(Required)

NJSIAA Compliance

To comply with New Jersey State Interscholastic Association (NJSIAA), the following requirement must be met: Good physical condition, freedom from injury and full recovery from illness shall be prerequisites to participation in athletics, whether in practice or in competition. Each candidate for a place on a school athletic squad or team shall be given a (complete) comprehensive physical examination by the medical doctor prior to the first practice session. If a pupil participates in more than one sport, the initial physical examination must be comprehensive. If the pupil has not sustained any serious injuries or illnesses prior to participation in another sport, the succeeding physical assessment may be of a more general nature. Each candidate must undergo at least one comprehensive physical examination per year. The parent or legal guardian shall receive a certificate or record card signed by the medical doctor testifying the candidate’s physical fitness or lack of physical fitness for the sport she has selected. The reasons for the medical doctor’s approval or disapproval for the candidate’s participation shall be registered thereon. The health findings of the medical examination for participation in athletics shall be made part of the general medical examination record. The NJSIAA strongly recommends that (1) students make application for participation in interscholastic athletics, and (2) for affixing the signatures of the parent/guardian to the parent permission form, the following should be considered for inclusion on the forms to comply with requirements of N.J.A.C. 6:29-6.4. Realizing that such activity involves the potential for injury which is inherent in all sports, I/we acknowledge that even the best coaching, use of protective equipment and strict observance of the rules, injuries are still a possibility. On rare occasions, these injuries can be so severe as to result in total disability, paralysis, or even death. I/we acknowledge that I/we have read and understand the warning. By entering your name below, you acknowledge that you have read and understand the above document.

Name(Required)

First Last

Parent/Guardian or Responsible Adult of an International Student(Required)

Coach(Required)

Date(Required)

Eligibility

Did you participate in HIGH SCHOOL athletics as a 7th or 8th grader in another state?(Required)

Yes

No

Emergency Information

Student Name(Required)

First Last

Student Homeroom(Required)

Parent/Guardian or Responsible Adult of an International Student(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent/Guardian or Responsible Adult of an International Student Phone Numbers - Home(Required)

Cell(Required)

Work

Name and telephone number of person to contact in case of an emergency:(Required)

First Last

Phone(Required)

Please list any allergies, including medicine or insects. If none, please write none.(Required)

Transportation Release

Student Name(Required)

First Last

Team(Required)

I certify that my daughter has my permission NOT to return to Holy Angels on the team bus after the athletic event. I will be responsible for her transportation at that athletic event.(Required)

Yes

No

Parent/Guardian or Responsible Adult of an International Student(Required)

First Last

Phone(Required)

Date(Required)

General Release Form

This release dated(Required)

is given BY: Each person who signs this release (Referred to as “I”) TO: The Academy of the Holy Angels and any parent, subsidiary, related or commonly owned company, as well as any teacher, instructor, coach, driver or other person acting on behalf of the Academy of the Holy Angels, (collectively referred to as “AHA). If more than one person signs this Release, “I” shall mean each person who signs this Release. 1. Release. I release and give up any and all claims and rights which I may have against AHA. This releases all claims, including those not mentioned in this Release. This Release applies to claims resulting from anything which has happened up to now and anything that may happen in the future (together, referred to as “Claims” ). I specifically release the following Claims: Those related to the participation of:

Student Name(Required)

First Last

Team Sport(Required)

(referred to as the "Activity") including transportation to and from the Activity. 2. Who is Bound. I am bound by this release. Anyone who succeeds to my rights and responsibilities, such as my heirs or the executor of my estate, is also bound. This Release is made for AHA’s benefit and all who succeed to AHA’s rights and responsibilities. 3. Insurance. I understand that AHA has made available to us, for the payment of a premium, certain insurance coverage with regard to injuries that might be sustained by the Student while participating in the Activity. 4. Permission to Participate. This release is given in consideration of AHA permitting the Student to participate in the Activity. 5. Agreement. I understand and agree to the terms of this Release.

Parent/Guardian or Responsible Adult of an International Student(Required)

First Last

General Rules and Regulations

1. Each student-athlete must have a physical before the first day of practice. The physical must be dated after June 1 and turned into the Health Office and a copy given to the coach. If the student-athlete has no physical, she may not tryout or participate in any way. 2. To be eligible to participate in athletics, each student-athlete must maintain a passing grade. If a player receives a Progress Report at any time during the quarter that she is failing, the student-athlete is suspended from practice and games until the grade is brought up to passing. Any student-athlete who receives an F on a Report Card is suspended for the remainder of the season. 3. Each player will attend and be on time for all games and practices unless the coach is notified and gives his/her permission. There must be sufficient cause for a student-athlete to be excused. (Proms, vacation, Big/Little Sister Day, doctor appointment, etc. are NOT excuses.) General rule: miss a game or practice….you will sit the next game. 4. No basketball student-athlete will be allowed to ski during the season, from the day after Thanksgiving through the last game of the season. 5. Each student-athlete is encouraged to attend all levels of every game, meet, or match in her particular sport. All student-athletes must attend all games after the regular season is completed (County and State Tournament games, meets, and matches. 6. Each student-athlete will obey the Code of Conduct at all times. She must portray good sportsmanship and a positive attitude toward her coaches as all as to other teams, officials, and teammates. 7. If a student-athlete has been invited to attend a Prom, holiday dance, semi-formal, or any other dance, or Holy Angels function, the student-athlete will attend the game, meet, or match, or practice first and then the function. 8. No student-athlete will receive a JV or Varsity letter or be nominated for All League or All County team status if she has become ineligible and has not returned to eligible status before the end of the season, portrays poor sportsmanship, exhibits negative attitude, continually breaks the rules of her sport. 9. Each student-athlete will have a 10:30pm curfew the night before all games, meets, and matches. If a social engagement in involved (i.e. Prom), the student-athlete is to be home immediately following the function. 10. If a student-athlete misses the bus to an away event, she may NOT drive to the game. Permission to drive must be obtained 24 hours prior to the event in the form of a letter from the student-athlete’s parents to the Administration. The approved note will be given to the Athletic Director. Busses leave for all game in the afternoon at 2:30 unless otherwise noted and for all night games at 4:00 unless otherwise noted. 11. No student-athlete will be able to go away during the season. (i.e. Labor Day weekend, Columbus Day weekend, Christmas break, February break, Easter break, Memorial Day weekend, etc.) Failure to comply with this rule will result in removal from the team. 12. Each student-athlete is required be present in her particular sport until after the State finals. This includes SENIORS ON SPRING SPORTS. Failure to comply with this rule will result in removal from the team. 13. Student-athletes who receive instruction from a professional in their sport are to see the pro on their own time, not during practice. Lateness or leaving early because of a private lesson will not be tolerated. 14. All game uniforms will be on and properly worn to and during warm-ups. At away games, when the team exits from the bus, all players will be properly attired. A student-athlete will not remove her game uniform until the game, meet, or match is finished. 15. All student-athletes must abide by the rules in the Handbook 16. If a student-athlete is involved in a Rules Violation: First Offense – suspension for next game, meet, or match Second Offense – suspension for two games, meets, or matches Third Offense – removal from team DRUGS, ALCOHOL, AND/OR SMOKING WILL NOT BE TOLERATED AT ANY SCHOOL RELATED ACTIVITIES AND WILL RESULT IN THE IMMEDIATE REMOVAL FROM THE TEAM. I will abide by all the above rules and regulations.

Student Name(Required)

First Last

Parent/Guardian or Responsible Adult of an International Student(Required)

First Last

Date(Required)

NJSIAA Steroid Testing Policy - Consent to Random Testing

In Executive Order 72, issued December 20, 2005, Governor Richard Codey directed the New Jersey Department of Education to work in conjunction with the New Jersey State Interscholastic Athletic Association (NJSIAA) to develop and implement a program of random testing for steroids, of teams and individuals qualifying for championship games. Beginning in the Fall, 2006 sports season, any student-athlete who possesses, distributes, ingests or otherwise uses any of the banned substances on the attached page, without written prescription by a fully-licensed physician, as recognized by the American Medical Association, to treat a medical condition, violates the NJSIAA’s sportsmanship rule, and is subject to NJSIAA penalties, including ineligibility from competition. The NJSIAA will test certain randomly selected individuals and teams that qualify for a state championship tournament or state championship competition for banned substances. The results of all tests shall be considered confidential and shall only be disclosed to the student, his or her parents and his or her school. No student may participate in NJSIAA competition unless the student and the student’s parent/guardian consent to random testing. >By signing below, we consent to random testing in accordance with the NJSIAA steroid testing policy. We understand that, if the student or the student’s team qualifies for a state championship tournament or state championship competition, the student may be subject to testing for banned substances.

Student Name(Required)

First Last

Parent/Guardian or Responsible Adult of an International Student(Required)

First Last

Date(Required)

Use and Misuse of Opioid Drugs Fact Sheet Student-Athlete and Parent/Guardian Sign-Off

In accordance with N.J.S.A. 18A:40-41.10, public school districts, approved private schools for students with disabilities, and nonpublic schools participating in an interscholastic sports program must distribute an Opioid Fact Sheet to all student-athletes. In addition, schools and districts must obtain a signed acknowledgement of receipt of the fact sheet from each student-athlete. Students under age 18, the parent or guardian must also sign. Here is the link to the Opioid Fact Sheet: https://www.nj.gov/education/students/safety/behavior/atd/opioid/FactSheet.pdf

Name of School(Required)

I/We acknowledge that we received and reviewed the Educational Fact Sheet on the Use and Misuse of Opioid Drugs.(Required)

Student Signature(Required)

Parent/Guardian Signature (also needed if student is under age 18)(Required)

Date(Required)

Acting to address the increased risk of opioid abuse among high school athletes, the Office of the New Jersey Coordinator for Addiction Responses and Enforcement Strategies (NJCARES) and the New Jersey State Interscholastic Athletic Association (NJSIAA) announced on February 19, 2019, a new partnership to educate student athletes and their parents/guardians on addiction risks associated with sports injuries and opioid use. This educational initiative, spearheaded by Attorney General Gurbir Grewal and approved by the Executive Committee of the NJSIAA, is a collaborative effort to use video programming to raise awareness among high school athletes that they face a higher risk of becoming addicted to prescription pain medication than their fellow students who do not play sports. Beginning with the 2019 fall season, we are making available to all student athletes and their parents/guardians, an educational video about the risks of opioid use as it relates to student athletes. The video will be available on August 1, 2019 and can be found on the NJSIAA website under “Athlete Wellness” which is located under the “Health & Safety tab. We are strongly encouraging student athletes and parents/guardians to watch the video as soon as it becomes available. An acknowledgement that students and their parents/guardians have watched the video will be required starting with the 2019-2020 winter season. All member schools are asked to add to their current athletic consent forms the sign-off listed below. The sign-off acknowledgment is an NJSIAA mandate; student athletes are required to view the video only once per school year prior to the first official practice of the season in their respective sport, but the signed acknowledgment is required for each sport a student participates in. Athletes that are 18 years or older do not need the parents/guardians to watch the video. Opioid Video is located at: https://youtu.be/3Rz6rkwpAx8 NJSIAA OPIOID POLICY ACKNOWLEDGEMENT We have viewed the NJ CARES educational video on the risks of opioid use for high school athletes. We understand the NJSIAA policy that requires students, and their parents(s)/guardian(s) if a student is under the age of 18, to view this video and sign this acknowledgement.

Student Signature(Required)

Date(Required)

Parent Signature(Required)

Date(Required)