SALIDA MIDDLE SCHOOL ATHLETICS

VERY IMPORTANT INFORMATION!!

PLEASE MAKE SURE ALL PAPERS ARE SIGNED BY THE STUDENT AND THE PARENT

STUDENTS ARE NOT ALLOWED TO PRACTICE WITHOUT INSURANCE INFORMATION AND PHYSICAL ON FILE IN THE SMS OFFICE. ALL PAPERWORKS MUST

BE TURNED IN TOGETHER.

Sports fees are due by the first game or meet or the student will not be allowed to participate. THERE ARE NO EXCEPTIONS!

Fees follow: $25/ sport for MS

$12.50 for reduced qualified MS Exempt for free lunch qualified students

Family Max per year (HS and MS) $150

Please call the Middle School Office or the Athletic Dept with questions.

SMS Office- 719-530-5302

Salida Schools Athletic Dept- 719-530-5406

ATHLETIC INSURANCE I understand the Salida School District, R-32-J DOES NOT provide accident insurance for students

participating in school sports or any other school activity.

CHECK ONE: ❑ I have accident insurance coverage: Company Name______________________________ Policy/Group#_________________

OR ❑ I have purchased student insurance made available through the Salida School District.

ATHLETIC EMERGENCY/CONSENT FORM NAME OF STUDENT:_____________________________________________________ PARENT/GUARDIAN: ____________________________________________________ HOME ADDRESS: ________________________________________________________ PHONE: Home (____ )_____________ Work: (____ )__________ Cell: (____)__________ EMAIL ADDRESS__________________________________________________________ EMERGENCY NUMBER IF NOT AT HOME OR WORK: (____ )___________________ FAMILY DOCTOR: __________________________________PHONE: (____ )_________ FAMILY DENTIST:__________________________________PHONE: (____)__________ I,_____________________________________________, parent or guardian of ______________________________________________, in consideration of my child’s opportunity to participate in interscholastic activities, hereby consent to emergency medical treatment, hospitalization or other medical treatment as may be necessary for the welfare of the above named child, by a physician, qualified nurse, and/or hospital, in the event of injury or illness during all periods of time in which the student is away from his/her legal residence as a member of an interscholastic activity team or group, and hereby waive on behalf of myself and the above named child any liability of the School District, any of its agents or employees, arising out of such medical treatment. Date ___________________________________ Signature of Parent of Guardian______________________________________________

Signature below acknowledges receipt and understanding of each of the required forms for SMS Athletics:

Salida Middle School Athletic Policy/Transportation Consent Salida School Drugs, Alcohol, & Tobacco Policy Warning to Students and Parents CHSAA Anti-hazing Policy CHSAA Student Eligibility Information Salida High School Athletic Council HRRMC ImPACT Testing Information

Additionally, the below signature is for CONSENT FOR COGNITIVE TESTING and RELEASE OF INFORMATION

I give my permission for my Student-Athlete to have a pre and post-concussion ImPACT (Immediate Post-concussion Assessment and Cognitive Testing) administered at Salida High School. I understand that my child may need to be tested more than once, depending upon the results of the test, as compared to my child’s baseline test, which is on file at Salida High School. I understand there is no charge for the testing.

Print Student Athlete Name

Student Athlete Signature Date

Parent/Guardian Signature Date

List Sports Participating in at SMS- This form is good for one school year.

The rest of this packet is FOR YOUR RECORDS! Please read the following policies which apply to all student athletes at SMS.

SALIDA MIDDLE SCHOOL ATHLETIC PARTICIPATION POLICY

The Activity Participation Policy has been developed to provide guidelines for all students participating in activities at Salida Middle School. Activities include but are not limited to school sponsored athletics, clubs and extracurricular activities such as dances, fun nights and other after school events. Any student participating in activities assumes the responsibility for the discipline required to follow these rules and guidelines. Parents should understand that they play an important role in their child’s participation in extracurricular activities and in the adherence to this set of policies.

● These Activity Participation Policy rules are in effect during the school year, in or out of school, and in or out of town.

● All rules established for Salida Middle School students must be followed. Please refer to Salida Middle School Student Handbook.

● Eligibility to participate in interscholastic athletics and school sponsored activities shall be determined through weekly eligibility requirements. If a student is failing any class or has two (2) D grades, then, he/she will be ineligible for one full week, which runs from Wednesday until Tuesday.

● Students will be expected to dress appropriately on trips and conduct themselves in accordance with the rules of Salida Middle School and this activity policy.

● If a student has an unexcused absence they will not participate in practice or contests held that day.

● Students will not be allowed to provide their own transportation to or from activities. Students will travel with their group and coach/sponsor. Permission may be granted for a student to ride with his/her parents if arrangements are made, in writing, before the activity, or at the activity if the parent contacts the coach/sponsor and provides a written statement that the son/daughter will be with the parent. The only exception to the above would be when a PERMISSION TO TRAVEL FORM is approved and on file in the athletic dept or middle school office prior to departure and a copy of the same is provided to the coach.

● Each coach has his/her set of rules for the sport he/she coaches. These rules have been approved by the Activities Director and/or Principal, are to be followed in addition to the rules in this Activity Policy, and are to be communicated by each coach to his/her players’ and the players’ parents at the start of the season.

● The following rule violations will subject the student to disciplinary action by the Athletic Council- the Principal, the Activities Director, and head coaches at Salida Middle School.

o Conduct unbecoming of a Salida Spartan. A student should not bring disrespect to the school, him/herself, teammates, or community during the school year by his/her actions, in or out of school, or in or out of town.

o Disrespect toward or willful disobedience toward a coach, teacher, or administrator.

● There shall be no tobacco use, drinking, using drugs, or criminal activity during the school year by any student representing the school. For students who begin practice before the first day of school; the first day of practice will constitute the beginning of the school year. Violation of this policy is subject to the District Policy(s) and the DRUG, ALCOHOL, & TOBACCO POLICY to be administered by the Activities Director.

*******************************TRANSPORTATION CONSENT****************************** I, the parent or guardian, hereby gives my consent and permission for my student to be transported to and from activities of Salida Middle School in which he/she is a registered participant via school conveyances. I understand and agree that I am responsible for the student during the trip and in the event the student should violate the rules established for students during the trip that:

A. Parent will be responsible for and hold the school district, its agents, servants, and employees harmless from any and all damages to persons or property caused by acts of the Student.

B. In the event of repeated or serious violations of the rules established for students, parent will accept a collect call concerning the

student, and I understand that the student will be sent home immediately by public transportation at my cost.

C. Parent and student understand and agree that the School District and its servants, agents, and employees do not assume any liability for loss or damage to any personal property owned by student and parent/guardian during the trip. We, the parent/guardian and student, further assume any and all risks that may arise in connection with traveling to and from the final destination of the trip.

D. Parent and student hereby agree to release and to save and hold harmless the School District, its agents, servants and employees from

any claim, loss, demand or cause of action of whatsoever nature or kind, excluding acts of willful misconduct or gross negligence, arising out of or incurred as a result of the student’s attendance and participation in the trip, including transportation, or as a result of the trip, or as a result of any claim, lawsuit or action of any kind filed against the School District by the student.

WARNING TO STUDENTS AND PARENTS

SERIOUS, CATASTROPHIC AND PERHAPS FATAL INJURY MAY RESULT FROM ATHLETIC PARTICIPATION.

By its very nature, competitive athletics may put students in situations in which SERIOUS, CATASTROPHIC and perhaps, FATAL ACCIDENTS may occur. Many forms of athletic competition result in violent physical contact among players, the use of equipment, which may result in accidents, strenuous physical exertion, and numerous other exposures to risk of injury.

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

By granting permission for your student to participate in athletic competition, you, the parent or guardian, acknowledge that such risk exists. By choosing to participate, you, the student, acknowledge that such risk exists. Students will be instructed in proper techniques to be used in athletic competition and in the proper utilization of all equipment worn or used in practice and competition. Students must adhere to that instruction and utilization and must refrain from improper uses and techniques. As previously stated, no amount of instruction, precaution, and supervision will totally eliminate all risk of serious, catastrophic, or even fatal injury. If any of the foregoing is not completely understood, please contact your school principal for further information. By signing off on the SHS Athletic Paperwork we acknowledge we have read and understand the material contained in the NOTICE TO ATHLETES AND PARENTS OR GUARDIANS. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

CHSAA ANTI-HAZING POLICY The Colorado High School Activities Association prohibits bullying, hazing, intimidation or threats. Hazing includes, but is not limited to humiliation tactics, forced social isolation, verbal or emotional abuse, forced or excessive consumption of food or liquids, or any activity that requires a student to engage in illegal activity. I understand that hazing of any type is not permitted in any CHSAA sanctioned activity. I will not engage in any of the prohibited conduct. I further understand that it is my responsibility to immediately report any acts of hazing that I become aware of to a sponsor, teacher, counselor, school support staff, coach or administrator in my school. By signing this acknowledgement, I affirm my responsibility to prevent and report hazing. I also understand that any violation of this could result in school or team consequences that could include dismissal from the activity or further disciplinary consequences and/or referral to law enforcement.

SALIDA HIGH SCHOOL DRUGS, ALCOHOL, AND TOBACCO POLICY

All students who choose to participate as athletes for Salida High School shall abide by the rules listed below. All accusations of rule violations must be reported to the Athletic Director/Principal by law enforcement officials or a reliable adult within 2 weeks of the infraction. The Athletic Director/Principal will investigate the allegation and render a decision as soon as possible. During the time of the investigation the athlete may be restricted from participation in any contest, not to exceed 1 week. The Athletic Director/Principal will notify the athlete and parent or guardian as soon as possible of the act of misconduct which the athlete has been accused. These rules will be in effect from the CHSAA official start of the fall sports season to the end of the CHSAA sports season. At no time, on or off school grounds, will an athlete be allowed to be under the influence of or in possession of alcohol, drugs, or tobacco (including e-cigarettes). The following consequences will be enforced for the violation of these rules: First Offense:

1. Suspended for 20% of the CHSAA allowable games for the sport. (see below) -OR- Schedule and meet with a

drug and alcohol counselor and enroll in a school approved education program. The Athletic Department will

help facilitate the meeting

2. Athlete and parent/guardian will meet with the Athletic Director & Principal.

Second Offense: 1. Suspended for 50% of the CHSAA allowable games for the sport.

2. Athlete and parent/guardian will meet with the Athletic Director & Principal.

3. Complete an approved drug, alcohol, and tobacco education program.

Third Offense: 1. Suspended one calendar year from all athletic team membership or competition.

2. Athlete and parent/guardian will meet with the Athletic Director & Principal.

3. Complete an approved drug, alcohol, and tobacco education program.

Subsequent Offenses: 1. Athlete and parent/guardian will follow the Third Offense steps.

Suspension: The Athlete will remain a member of the team and can participate in all practices and team activities, but may not play in any scrimmages or games. Scrimmages do not count toward fulfilling game suspensions. The suspension ends when all requirements have been met. If the suspension is at the end of the season in which the full penalty cannot be assessed, the penalty shall carry over to the next sports season in which the athlete participates in. If the student is not involved in a sport at the time of the violation, the student shall serve the suspension during the first sports season in which they are involved in. All numbers 0.5 or above will be rounded up to include the next game. (Example: 20% of 19 baseball games would be 3.8 games. The player would miss 4 games). Appeals: The athlete and parent/guardian may appeal the decision of the Athletic Director/Principal within three days to the Athletic Council. The Athletic Council’s decision will be final.

ATHLETIC COUNCIL

The Athletic Council exists as a formal process for the discussion and resolution of concerns, conflicts, and disciplinary actions. This is the final step of the grievance procedure for all athletes and parents.

- Step 1: Discussion with the coach

- Step 2: Meet with the Athletic Director and/or Principal

- Step 3: Formal meeting with the Athletic Council The Athletic Council will consist of the Athletic Director, an Administrator, various Head Coaches, Student Council Member, School Board Member, and one or more community member(s). If the grievance is taken to the Athletic Council, the Athletic Director, coach, and athlete/parent or guardian agree that the Council’s decision will be final. By signing the required athletic paperwork, we acknowledge we have read, understand, and agree to follow the grievance procedure.

Heart of the Rockies Regional Medical Center Salida High School Dear Parent/Guardian, Heart of the Rockies Regional Medical Center has implemented an innovative program at Salida High School for the student-athletes. This program will assist our physicians/athletic trainer in evaluating and treating head injuries (e.g., concussion). In order to better manage concussions sustained by student-athletes, we have acquired a software tool called ImPACT (Immediate Post Concussion Assessment and Cognitive Testing). ImPACT is a computerized exam utilized in many professional, collegiate, and high school sports programs across the country to successfully diagnose and manage concussions. If an athlete is believed to have suffered a head injury during competition, ImPACT is used to help determine the severity of head injury and when the injury has fully healed. The computerized exam is given to athletes before beginning contact sport practice or competition. This non-invasive test is set up in “video-game” type format and takes about 20 minutes to complete. It is simple, and actually many athletes enjoy the challenge of taking the test. Essentially, the ImPACT test is a preseason physical of the brain. It tracks information such as memory, reaction time, speed, and concentration. It, however, is not an IQ test. If a concussion is suspected, the athlete will be required to re-take the test. Both the preseason and post-injury test data is given to a doctor to help evaluate the injury. The test data will enable these health professionals to determine when return-to-play is appropriate and safe for the injured athlete. If an injury of this nature occurs to your child, you will be promptly contacted with all the details. I wish to stress that the ImPACT testing procedures are non-invasive, and they pose no risks to your student-athlete. We are excited to implement this program given that it provides us the best available information for managing concussions and preventing potential brain damage that can occur with multiple concussions. The Salida High School administration, coaching, and HRRMC athletic training staffs are striving to keep your child’s health and safety at the forefront of the student athletic experience. If you have any further questions regarding this program please feel free to contact me at 719-530-2028 or dan.evans@hrrmc.net. Sincerely, Dan Evans, MLS, ATC Certified Athletic Trainer Heart of the Rockies Regional Medical Center 550 W Hwy 50 Salida, CO 81201