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Marching Band Package 2016 Season

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MARCHING!BAND!MEMBERSHIP!CONTRACT!

2016!SEASON!–!PAGE!1!

!Parents/Students:!

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Please!read!ALL!of!the!following!information!and!return!all!information!that!requires!a!signature!

and!any!required!monies!by!June!4,!2016.!

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STUDENT!NAME:________________________________________________________________________________!!

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CCSD!STUDENT!ID#:_________________________________!GRADE!LEVEL!2016T2017__________!

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MARCHING!INSTRUMENT:____________________________________________________________________!

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PHYSICAL!ADDRESS:!

! ! ! Subdivison___________________________________________________________!

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! ! ! Street!Address_______________________________________________________!

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! ! ! City/State/Zip________________________________________________________!

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STUDENT!EMAIL!ADDRESS:________________________________________________________________!

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PARENT(S)!EMAIL!ADDRESSES:__________________________________________________________________!

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T!SHIRT!SIZE:____________________! SNEAKER!SIZE!(for!marching!shoes):_______________________!

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MARCHING!BAND!DEPOSIT!$200!PAID______________! WATER!JUG!$10!PAID_______________!

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I"have"read"and"understand"all"policies"and"procedures"set"forth"in"the"201672017"Marching"Band"Membership"contract"and"understand"I"am"entering"into"a"financial"agreement"with"Hillgrove"Band"Boosters"Association,"a"501(c)3"nonprofit"group.""I"agree"to"pay"fees"and/or"fundraise"to"the"best"of"my"ability.""I"acknowledge"payment"in"full"of"band"fees"ensures"“good"standing”"status,"which"enables"student"to"participate"in"optional"band"activities"and"trips"during"the"201672017"school"year.""Student!Signature:______________________________________________! Date:_________________________!

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Parent!Signature:_______________________________________________! Date:_________________________!

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MARCHING!BAND!MEMBERSHIP!CONTRACT!

2016!SEASON!–!PAGE!2!

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REQUIRED!ITEMS!

!Marching!band!is!an!extra0curricular!activity!that!requires!a!few!items!that!are!necessary!to!our!“sport”.!!!!The!items!below!are!required!for!all!marching!band!students.!!Some!items!below!are!optional!(as!indicated),!and!are!available!thanks!to!our!band!booster!parents!and!their!commitment!to!support!our!students.!!!Please"see"page"10"for"other"information/details"for"optional"meals,"etc.!

!"REQUIRED"FOR"SUMMER"BAND"CAMP:"!Item! ! ! ! ! ! ! ! ! Cost! ! Deadline!for!Payment!Black!water!jug!(ordered!by!band)! ! ! ! ! $10! ! June!30th!!!!!!REQUIRED"FOR"MARCHING"SEASON:"!Item! ! ! ! ! ! ! ! ! Cost! ! Deadline!for!Payment!MTX’s!(specific!marching!band!shoes/ordered!by!band)!! $40! ! August!12th!!

*SOLID!BLACK!long!socks! ! ! ! ! ! $507! ! ! !

*SOLID!BLACK!athletic!shorts!(like!Under!Armour/Champion!brand)! $10025!

*SOLID!LACK!athletic!shirt!(like!Under!Armour/Champion!brand)! $10025!

Colorguard!will!have!their!own!items!that!are!required! ! $50+! ! Guard!will!share!details!

*Students)need)to)purchase)before)August)19th)football)game)to)wear)under)uniform)

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!!!!!Each!member!of!the!ensemble!must!read!and!agree!to!the!terms!as!follows!in!order!to!participate.!!In!return,!the!Hillgrove!Marching!Band!and!its!staff!will!provide!all!necessary!instruction,!materials,!travel,!and!experiences!in!order!to!insure!a!safe,!productive,!and!rewarding!experience.!!PLEASE!RETURN!ALL!THE!NECESSARY!ATTACHED!FORMS!WITH!YOUR!$200!DEPOSIT!BY!JUNE!4,!

2016.!!THE!$200!DEPOSIT!MUST!BE!RECEIVED!TO!ENSURE!A!SPOT!FOR!THE!2016!MARCHING!

SEASON.!

!!ATTENDANCE!POLICY:!!

1. A!full!rehearsal!and!performance!calendar!is!attached.!2. All!rehearsals!and!performances!are!MANDATORY.!3. Students!who!must!miss!a!rehearsal!must!report!their!absence!via!

http://www.hillgroveband.com/the0essentials/absence0request/!4. Absences!must!be!reported!2!DAYS!in!advance.!5. Last0minute!absences!such!as!illness!or!family!emergency!should!be!reported!to!Mr.!Erwin!within!

a!reasonable!time!frame.!6. If!you!are!absent!from!school,!please!bring!Mr.!Erwin!the!attendance!note!the!day!you!return.!7. Absences!from!performances!will!not!be!permitted!except!in!the!most!extenuating!circumstances.!8. Rehearsals!begin!on!time!and!will!end!on!time.))The)times)of)rehearsals)DO)NOT)include)travel)time)

or)setup)and)stowing)of)equipment.!!Expect!your!student!to!take!10015!minutes!to!prepare!on!either!side!of!rehearsal!time.!

9. Tardies!to!rehearsal!are!only!permitted!for!tutoring.!!Club!meetings!are!not!excused.!!You!must!communicate!with!your!club!sponsor!your!obligations!to!the!ensemble.!

!ATTENDANCE!CONSENQUENCES:!!

1. Absences!will!be!judged!to!be!EXCUSED!or!UNEXCUSED!at!the!discretion!of!the!directors.!!A!general!rule!to!follow!is!that!if!CCSD!will!excuse!it,!so!will!we.!!

2. ANY!UNEXCUSED!ABSENCE!during!the!week!of!the!performance!WILL!result!in!the!student!in!question!being!sidelined!for!the!upcoming!performance.!!

3. After!August!4th,!2016!0!THREE!unexcused!absences!in!the!course!of!the!result!will!result!in!removal!from!the!ensemble.!

4. If!you!are!sidelined,!you!must!still!attend!IN!UNIFORM.!5. Any!instance!of!ISS!or!OSS!will!be!considered!UNEXCUSED.!!You!may!not!attend!rehearsal!if!you!

are!suspended.!6. Unexcused!tardies!will!be!made!up!prior!to!or!after!rehearsal!BEFORE!the!following!performance.!!

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REHEARSAL/PERFORMANCE!SCHEDULE!

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JULY!2016!

! BAND!CAMP:!July!18th!–!July!22nd!!0!9:00am!–!9:00pm!! POST!CAMP:!July!25th!–!July!27th!–!6:00pm!–!9:00pm!! POST!CAMP!PERFORMANCE/COOKOUT:!July!29th!evening)!!

Once"school"starts,"weekly"rehearsals"are"as"follows:"! MONDAY:!4:00pm!–!7:00pm!(some!outside!work!&!sectionals)!! TUESDAY:!4:30pm!–!7:30pm!!! THURSDAY:!4:30pm!–!7:30pm!!

AUGUST!2016!

! WEEKEND!REHEARSALS!

AUGUST!26TH!0!4:30!PM!–!7:30!PM!(Friday!night/no!football!game)!AUGUST!27TH!!0!9:00!AM!–!6:00!PM!

PERFORMANCES!

! ! AUGUST!19th!–!Football/Corky!Kell!@!McEachern!SEPTEMBER!2016!

! WEEKEND!REHEARSALS!

! ! SEPTEMBER!17th!T!!9:00AM!–!6:00PM!! PERFORMANCES!

! ! SEPTEMBER!2nd!T!Football!vs!North!Gwinnett!!! ! SEPTEMBER!9TH!T!Football!@!West!Forsyth!! ! SEPTEMBER!16TH!0!Football!vs!Campbell!! ! SEPTEMBER!23RD!–!Football!@!South!Gwinnett!!OCTOBER!2016!

! WEEKEND!REHEARSALS!

! ! OCTOBER!8th!T!!9:00AM!–!6:00PM!! PERFORMANCES!

! ! OCTOBER!7th!T!Football!@!N!Paulding!! ! OCTOBER!10TH!–!Cobb!Marching!Band!Exhibition!at!McEachern! !

OCTOBER!14th!–!Football!vs.!Marietta!(Homecoming/Pink!Out)!OCTOBER!15th!–!Competition!Day!0!TBA!OCTOBER!21st!–!Football!@!Kennesaw!Mountain!OCTOBER!22nd!–!Competition!Day!0!TBA!OCTOBER!28th!T!Football!vs!North!Cobb!(Senior!Night)!OCTOBER!29th!–!Competition!Day!0!TBA!

NOVEMBER!2016!

! PERFORMANCES!

! ! NOVEMBER!6th!T!Football!@!McEachern!

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BAND!FEE!SCHEDULE!

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MARCHING!BAND!

Kickoff!is!June!3rd!for!the!2016!season.!!Commitment!forms!will!be!available!and!sent!home!with!students!prior!to!spring!marching!band!camp!weekend.!!Student!Activity!Fees:!

!$200!non0refundable!deposit!with!contract!by!JUNE!4TH!!$200!due!by!JUNE!30th!!$200!due!by!JULY!31st!!$200!due!by!AUGUST!30th!!$200!due!by!SEPTEMBER!31st!!TOTAL! !$1,000!total!!

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Additional!Expenses!that!MAY!occur!depending!on!participation!level:!

! HHS!Band!Water!bottle!(former)marching)band)members)can)reBuse)last)year’s)black)jug)if)in)good)condition))! MTX!Marching!Shoes!or!Colorguard!Shoes!(if)new)pair)is)needed)this)year))! Uniform!Gloves!(WW!and!Brass,!and!Colorguard)!!! Dri!Fit!shirt!and!shorts!for!under!uniform!! Additional!Colorguard!Items!(makeup/hair!supplies/unitard)!! Friday!Football!Game!Meal!Plan!and/or!cost!of!other!meals!during!the!season!!!!!**Along!with!adjustment!of!activity!fee!schedule,!the!following!incentive!is!being!offered!again**!

!With!full!upfront!payment!of!2016!marching!band!activity!fees!by!June!30th!!(hard!deadline),!a!

$100!discount!will!be!given!making!the!activity!fee!$900!instead!of!$1,000.!

!1.!!Bring!cash!or!check!(preferably!check)!to!the!band!hall!payable!to!Hillgrove!Bands!Booster!Association!and!place!it!in!the!black!lock!box!in!the!band!room!designated!for!this!purpose.!!Your!cancelled!check!will!be!your!receipt.!!Please!be!aware!that!Cobb!County!Policy!prohibits!the!Band!Directors!from!receiving!your!payment.!!!If!paying!in!cash,!you!must!receive!a!written!receipt!before!funds!will!be!accepted.!!!! !2.!!Credit!Card!Payment!via!PayPal!on!the!website:!!www.hillgrovebands.com.!! !3.!!Checks!only!may!be!mailed!to!Hillgrove!Bands!to!our!P.O.!Box!(postmarked!by!the!June!30th!deadline)!!(*NOTE:!!There!is!a!$35!fee!assessed!for!any!returned!check.)!! !

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Hillgrove!Bands!Booster!Association,!Inc.!

2016T2017!Projected!Fundraisers!

!Sustaining!a!quality!band!program!requires!support!over!and!above!that!which!is!provided!through!the!instructional!programs!supported!by!the!Cobb!County!School!District.!!Fundraising!is!necessary!to!meet!these!additional!costs.!!In!an!effort!to!help!meet!the!needs!of!the!general!band!fund!and!to!assist!students!in!payment!of!band!fees,!the!following!fundraisers!are!projected!for!the!201602017!School!Year.!!Some!fundraisers!go!directly!to!support!the!general!fund,!which!benefits!the!band!as!a!whole.!!Other!fundraisers!will!be!designated!as!100%!band!fees!(to!assist!with!student!accounts).!!!!While!it!is!realized!that!you!and!your!student(s)!may!not!be!able!to!participate!in!all!fundraisers,!the!following!information!is!provided!to!assist!you!in!planning.!!Additional!fundraisers!may!be!added!should!the!need!for!additional!funds!be!identified.!!!!

Fundraiser! Projected!Date!

Funds!applied!

toward!

Scrip! On0going! 100%!Band!Fees!

Cookie!dough! August! 100%!Band!Fees!

Annual!Fund!Letters! Begins!Summer! 100%!Band!Fees!

Reviewing!New!Options! Summer!and!Early!Fall! 100%!Band!Fees!

Pine!Straw!Fundraiser! Fall!and!Spring! 100%!Band!Fees!

March0A0Thon! Fall! 100%!General!Fund!

Flocking! On0going! 100%!General!Fund!

Restaurant!Nights! On0going! 100%!General!Fund!

Taste!of!West!Cobb! April/May! 100%!General!Fund!

!Miscellaneous!HBBA!Information!

!Our!Booster!is!a!non0profit!organization!with!a!501C3!from!the!IRS.!!We!operate!within!the!rules!and!regulations!set!forth!from!this!group,!as!well!as!Cobb!County!School!District’s!rules!for!Booster!Clubs.!!!!We!have!By0Laws,!Elected!Officers,!Committee!Chairs,!and!operate!solely!to!support!the!efforts!of!the!band!program.!!We!are!here!to!make!this!program!the!best!we!can!for!the!students!who!participate!in!both!concert!and!marching!band.!!Volunteers!are!needed!and!appreciated!!!Current!Elected!Officers!and!Committee!Chairs!are!listed!on!the!band!website!at!www.hillgroveband.com.!!This!is!our!main!place!for!information,!including!spirit!wear,!calendar,!announcements,!and!requirements,!as!well!as!other!HBBA!details.!!!!!

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FINANCIAL!ASSISTANCE!!

HBBA!is!prepared!to!offer!financial!assistance!for!those!families/students!who!have!the!greatest!need!for!support.!!We!are!sensitive!to!each!family’s!individually!unique!situation!and!will!attempt!to!do!all!we!can!to!help.!

!To!apply!for!HBBA!financial!assistance,!the!following!is!due!on!or!before!May!30th!for!

consideration!for!the!2016!season:!!

1. This!form,!filled!out!fully!2. An!essay!written!by!the!STUDENT!as!to!why!they!would!like!to!participate!in!the!marching!

band,!what!benefits!it!would!bring!them!personally,!AND!what!they!will!bring!to!the!group.!3. Families!MUST!agree!to!participate!in!fundraising!activities!to!receive!HBBA!financial!

assistance.!!If!this!is!not!satisfied,!financial!assistance!will!not!be!an!option!for!future!years.!!

APPLICATION!FOR!FINANCIAL!ASSISTANCE!

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Student!Name:____________________________________! ! Grade:!9!!10!!11!!12!!

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Section/Instrument:_______________________________________!

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Parent!Name(s):____________________________________________________________________________________!

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Email!Address(es):_________________________________________________________________________________!

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Phone!Number(s):!_________________________________________________________________________________!

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We!are!applying!for!the!following!assistance!level!(circle):!

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Up"to"80%"Tuition"Assistance" " Partial"Assistance" " ""Alternate"Payment"Plan"(please"include"details/plan"requested)"

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***By!signing!below!we!acknowledge!that!our!financial!situation!will!be!reviewed!by!the!Executive!

Board!of!the!Hillgrove!Band!Boosters!Association!and!that!we!will!be!required!to!participate!in!

fundraising!activities!offered!by!HBBA!to!satisfy!our!financial!assistance!agreement.!

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Parent!Signature:_________________________________________________!Date:_________________________!

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MARCHING!BAND!SEASON!

General!Information!for!our!Families!

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!We!perform!a!custom!show!each!year,!and!this!means!some!additional!expenses!0!but!we!think!it’s!worth!the!extra!cost!for!our!students.!!A!custom!show!means!our!marching!band!performs!something!special!that!sets!them!apart!from!all!others.!!Our!marching!band!fees!are!one!of!the!most!cost0effective!in!Cobb!County,!and!have!remained!the!same!for!the!last!7!years.!!Some!of!!the!items!that!are!included!in!HBBA’s!budget!(Hillgrove!Band!Booster!Association)!that!pays!for!a!few!of!our!big!marching!band!expenses!includes!the!following:!!!

Custom!drill!! ! ! ! ! ! ! $10,000!Custom!music!arrangement!and!music!license! ! $10,000!Transportation!for!competitions!–!buses!for!students! $12,000+!Marching!band!staff!and!sectional!coaches!! ! $60,000+!Colorguard!outfits,!flags,!etc!.! ! ! ! $10,000+!Props! ! ! ! ! ! ! ! $5,000+!Show!shirts!for!every!marching!band!student! ! $1,400+!!!

While!this!is!not!all!of!the!expenses!that!cover!marching!band,!this!is!a!short!list!of!some!of!our!larger!items.!!We!share!this!in!the!spirit!of!transparency!as!well!as!to!encourage!our!band!families!to!pay!or!fundraise!to!cover!marching!band!fees.!!**Marching"band"fees"will"remain"$1,000"for"201672017,"and"we"will"offer"a"10%"discount"again"this"year"for"each"student"who"pays"$900"in"full"by"June"30th"(hard"deadline/no"extensions)."!

HBBA!offers!many!opportunities!to!fundraise!which!helps!offset!student!fees.!!We!encourage!everyone!to!take!advantage!of!this!opportunity.!!!!**New!this!year:!

We!will!also!have!the!201602017!Annual!Fund!letters!uploaded!by!June!1st,!and!require!each!marching!band!student!to!mail!at!least!5!to!help!fundraise.!!All!proceeds!raised!from!Annual!Fund!letters!go!directly!to!the!student’s!ledger!to!offset!fees.!!Updated!Annual!Fund!letters!will!be!posted!on!the!Hillgrove!Band!website!at!www.hillgroveband.com.!!!!!!!!!

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OPTIONAL!ITEMS!FOR!MARCHING!BAND!SEASON!

Shirts/shorts/athletic!socks/good!athletic!shoes!for!practice!

Sunscreen.!Sunglasses/hats,!Snacks!(as!needed)!

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OPTIONAL"MEALS"FOR"MARCHING"SEASON:"

! Dinners!during!summer!band!camp!–!week!of!July!18th!–!22nd!Cost!approx.!$40/student!to!cover!dinner!each!night.!!Details!shared!by!spring!camp.!!!

! “Friday!Meals”!–!dinner!on!football!game!night,!Cobb!Exhibition,!etc.!!!Expect!$7/student!for!each!meal.!!Meals!feature!Chick0fil0a,!Zaxby’s,!Moe’s,!Pizza!Night,!Sub!sandwiches,!etc.!!Meals!include!entre’,!side,!fruit/veggie,!dessert,!water!bottle!and!will!begin!on!August!19th!for!the!first!football!game.!!Details/schedule!expected!for!distribution!during!summer!band!camp!with!payment!due!first!part!of!August.!!Student!is!welcome!to!bring!their!own!meal!from!home!in!lieu!of!purchasing!a!meal!to!eat!with!the!group.!!!

! “Competition!Meals”!–!breakfast/lunch/dinner!options!for!competition!Saturdays!in!October.!!!!Expect!$8/student!for!each!meal.!!!!Meal!information!will!be!distributed!with!options!for!each!competition!by!September!and!payment!must!be!received!by!deadline!to!participate.!!Student!is!welcome!to!bring!their!own!meal!from!home!in!lieu!of!purchasing!a!meal!to!eat!with!the!group.!

!!!*)Details,)price,)schedule)will)be)distributed)over)the)summer.))Payment)must)be)received)for)student)to)participate.))

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Hillgrove Band Boosters Association 3600 Dallas Hwy, Suite 230-155 Marietta, GA 30064

Hillgrove)Band)Boosters)Association,)Inc.)is)a)501(c)(3))organization.))

Contributions)to)a)student’s)individual)band)account)are)not)typically)tax)deductible.)Please)consult)a)qualified)tax)professional)for)other)details.!

Dear

I am a member of the Hillgrove High School Marching Band, and I need your help during our Annual Fund drive for the 2016-2017 school year.

We are a competitive, award-winning marching band with over 170 members. We compete against other marching bands at both local, state, and national levels, in addition to performing and providing spirit and support at all Hillgrove football games and marching in community parades. It’s lots of fun, but it takes a lot of work!

Our show for the 2016 fall season, “_________________”, features music from several well-known artists that has been custom arranged just for us. Not only is the music going to be awesome, so will the choreography, props, flags, and colorguard costumes! I’m excited about it and I know the show will be great!

While many of my friends are still sleeping in and chilling out this summer, I’ll be on the practice field spending hours in the sun, as of July 18th, learning both the show music and the formations of the marching drill. Once school starts, we will keep right on practicing in the evenings after school and even on some Saturdays!

We keep this up right through October, when everything comes together for our competitions. This year we will perform at several local competitions, and at the end of October our group will return to the Georgia Dome in Atlanta for a large marching band competition that will feature over 35 bands from many different states. We regularly compete against some of the best high school marching bands in the country throughout the season.

Putting on a custom, competitive marching band show is expensive. The cost of instructors and staff, equipment, uniforms, props and travel adds up to tens of thousands of dollars each year for our band, but we also gain things that money can’t buy. We learn discipline, self-control, and teamwork, along with how hard work really does pay off and what it means to be part of something bigger than ourselves.

These are lessons that will help me for the rest of my life. And I need your help.

I am asking my friends, neighbors, and relatives for contributions to support my band program that will also be an investment in my future. One hundred percent of your contribution will go directly to my individual fundraising efforts.

Please complete page two of this letter and send it in with your check. Make out your check to “HBBA” (Hillgrove Band Booster Association) and remember to write my first and last name and ‘Annual Fund’ in the memo line of your check. Checks can be turned in to the Hillgrove High School band room or mailed to the address listed in the upper left. You can also contribute via credit card by going to www.hillgroveband.com and clicking the “PayPal” link at the bottom of the page, or contacting one of our band officers to run any credit card via Square payment system.

Thank you in advance for your kindness and generosity!

Sincerely,

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Thank you for your donation! !

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Please&complete&the&following&and&submit&with&your&donation&so&that&you&may&receive&proper&recognition&and&thanks:&

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Name:! !

Address:!!

City,!State!&!Zip:! !

Daytime!Phone:!!

Email:!!

Donation!Amount:!!

Check!#:!!

Student(s)!you!are!Supporting:! !

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On&behalf&of&all&the&student&members&of&Hillgrove&Bands,&please&accept&our&gratitude&for&&your&generous&support&of&our&band&program.&

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Hillgrove Band Boosters Association 3600 Dallas Hwy, Suite 230-155

Marietta, GA 30064

Annual!Fund!Giving!Ranges!and!Thank!You!Gifts! $25L!$74!

$75L!$249!

$250L!$499!

$500L!$999!

$1000!&!up!

Recognition!on!Hillgrove!Bands!Sponsor!Board!!! ! ! ! •!!

Recognition!on!sponsor!page!of!Hillgrove!Bands!website! ! ! •! •! •!

Cobb County School District 2016-2017 School Year

ATHLETIC PARTICIPATION, WAIVER, INSURANCE, AND CONSENT FORM *Parent/Guardian(s) and Student signature required at bottom of form & initials required as indicated below

PLEASE PRINT Student Name________________________________________________________________________ _______________ (Last) (First) (Middle) (Grade Level 2016-17) Address ______________________________________________________________________________________________ (Street) (City) (Zip) _________________________ _________________________ __________________ _______________ (Parent Cell Phone #) (Parent Alternate Phone #) (Year Entered 9th Grade) (Date of Birth)

PARENT/GUARDIAN CONSENT FOR ATHLETIC PARTICIPATION

*Parent/Guardian and Student must both initial in blanks before each bold section below

__________ __________ ACKNOWLEDGEMENT OF RISK: I understand and acknowledge that participation in inter- Parent/Guardian Student scholastic sports teams/clubs and events is voluntary and by its very nature possesses an actual or potential risk of emotional and physical injury/illness, which may range in severity from minor to long term catastrophic injury, up to permanent paralysis or death. While it is not possible to eliminate this risk, Students have the responsibility to help reduce the chance of injury. Students must obey all safety rules, report all physical problems to their coaches or supervisors follow a proper conditioning program and inspect equipment daily. Parents/Guardians or Students who do not wish to accept this risk should not sign this form. __________ __________ INSURANCE COVERAGE: I am aware there is no District insurance coverage for medical Parent/Guardian Student treatment of personal injuries or property damage which may arise out of Student’s participation in inter-scholastic athletics, sports clubs and events. I understand my Student must have insurance coverage in order to participate.

Please CHECK one of the following statements regarding insurance coverage for Student for the current school year: ____ Student is adequately and currently covered by accident insurance that will cover injuries sustained while participating in inter-scholastic athletics, sports teams/clubs and events. Insurance Company: ______________________________________ Company Phone Number: ________________________________ Name of Insured: _________________________________________ Policy Number: ________________________________________ ____ I wish to purchase the Benefit Plan provided by the Cobb County School System. (A copy of this Benefit Plan should be attached) __________ __________ PHYSICAL EVALUATION AND MEDICAL TREATMENT: Per Georgia High School Parent/Guardian Student Association (GHSA) a Pre-participation Physical Evaluation must be performed by a physician (MD/DO), nurse practitioner or physician assistant to medically screen each student who participates in District athletic programs. I understand that this medical evaluation is general in nature and only performed for purpose of determining fitness for athletics. In case of an emergency or accident on/off school grounds during any school activity or athletic event, which in the opinion of school authorities requires immediate medical or surgical attention, I hereby grant permission to physicians, consulting physicians, certified athletic trainers, emergency medical technicians, and other healthcare providers selected by school authorities to provide medical care and treatment (including hospitalization if deemed appropriate) unless I am present and request otherwise or until I later request otherwise.

__________ __________ REVIEW OF ATHLETIC HANDBOOK (including Board Policy IDF-R Athletic Code of Parent/Guardian Student Conduct): I acknowledge that I have reviewed and consent to the guidelines of the Student/Parent Athletic Handbook, which can be found on the Athletics page of the Cobb County School District website (cobbk12.org), the local high school website, or by request of a hardcopy to the local high school. I understand that both Student and Parent/Guardian are subject to the rules outlined in this handbook and that violations may result in school discipline and consequences up to Student’s loss of the privilege of athletic participation and/or loss of Parent(s)’/Guardian(s)’ privilege of attending athletic events. I have read and understand the consequences of certain behavior(s) as outlined in the Code of Conduct.

________ _____ TRANSPORTATION AND TRAVEL: I acknowledge my understanding of the travel-related Parent/Guardian Student guidelines as outlined within the Student/Parent Athletic Handbook, including the responsibility of parent/guardian to arrange transportation when not District-provided. I consent for my Student to participate in school-sponsored athletic trips.

__________ _________ WAIVER: I assume all liability and responsibility for any and all potential or real risks, injuries or Parent/Guardian Student even death which may result from Student’s participation in inter-scholastic athletics, sports teams/clubs and events. I represent and warrant that I know of no mental or physical condition that would make it unsafe for Student to participate in inter-scholastic athletics, sports teams/clubs and events. I understand, acknowledge, and agree that the Cobb County School District (CCSD) shall not be liable for any injury/illness suffered by the Student which arises out of and/or is associated with preparing for and/or participating in inter-scholastic athletics, sports teams/clubs and events. I hereby release, discharge, indemnify, and agree to hold harmless the CCSD District, Members of the CCSD Board of Education, its past, present and future officers, attorneys, agents, employees, predecessors and successors in interest, and assigns, hereinafter “CCSD releasees”, from any and all liability arising out of or in connection with Student’s participation in inter-scholastic athletics, sports teams/clubs and events. For purpose of this Release, liability means all claims, demands, losses, causes of action, suits, or judgments of any kind that Student or Student’s parents, guardians, heirs, executors, administrators, and assigns have or may have against the CCSD releasees because of Student’s personal, physical, or emotional injury, accident, illness or death, or because of any loss of or damage to property that occurs to Student or his or her property during Student’s participation in inter-scholastic athletics, sports teams/clubs and events due to acts of passive or active negligence by CCSD releases other than actions involving fraud or actual malice. By signing below, you acknowledge that you have carefully read this voluntary Waiver and understand the potential dangers incident to engaging in inter-scholastic athletics, sports teams/clubs and events, and are fully aware of the legal consequences of this agreement.

SIGNATURE:

By signing below, Parent/Guardian and Student hereby agree to/give consent for participation in inter-scholastic athletics, sports teams/clubs and events for Cobb County School District of the below-indicated Student. You acknowledge that you have carefully reviewed and agree to all terms of athletic participation, including the voluntary waiver, verify that all information contained herein is accurate, and understand that any false information may result in Student’s ineligibility for athletic participation.

____________________________________ ____________________________________ ____________ Signature(s) of Parent(s)/Guardian(s) Printed Name of Parent(s)/Guardian(s) Date ____________________________________ ____________________________________ ____________ Signature of Student Printed Name of Student Date

■ Preparticipation Physical Evaluation HISTORY FORM

(Note: This form is to be filled out by the patient and parent prior to seeing the physician. The physician should keep this form in the chart.)

Date of Exam ___________________________________________________________________________________________________________________

Name __________________________________________________________________________________ Date of birth __________________________

Sex _______ Age __________ Grade _____________ School _____________________________ Sport(s) __________________________________

Medicines and Allergies: Please list all of the prescription and over-the-counter medicines and supplements (herbal and nutritional) that you are currently taking

Do you have any allergies? � Yes � No If yes, please identify specific allergy below. � Medicines � Pollens � Food � Stinging Insects

Explain “Yes” answers below. Circle questions you don’t know the answers to.

GENERAL QUESTIONS Yes No

1. Has a doctor ever denied or restricted your participation in sports for any reason?

2. Do you have any ongoing medical conditions? If so, please identify below: � Asthma � Anemia � Diabetes � InfectionsOther: _______________________________________________

3. Have you ever spent the night in the hospital?

4. Have you ever had surgery?

HEART HEALTH QUESTIONS ABOUT YOU Yes No5. Have you ever passed out or nearly passed out DURING or

AFTER exercise?

6. Have you ever had discomfort, pain, tightness, or pressure in your chest during exercise?

7. Does your heart ever race or skip beats (irregular beats) during exercise?

8. Has a doctor ever told you that you have any heart problems? If so, check all that apply: � High blood pressure � A heart murmur� High cholesterol � A heart infection� Kawasaki disease Other: _____________________

9. Has a doctor ever ordered a test for your heart? (For example, ECG/EKG, echocardiogram)

10. Do you get lightheaded or feel more short of breath than expected during exercise?

11. Have you ever had an unexplained seizure?

12. Do you get more tired or short of breath more quickly than your friends during exercise?

HEART HEALTH QUESTIONS ABOUT YOUR FAMILY Yes No13. Has any family member or relative died of heart problems or had an

unexpected or unexplained sudden death before age 50 (including drowning, unexplained car accident, or sudden infant death syndrome)?

14. Does anyone in your family have hypertrophic cardiomyopathy, Marfan syndrome, arrhythmogenic right ventricular cardiomyopathy, long QT syndrome, short QT syndrome, Brugada syndrome, or catecholaminergic polymorphic ventricular tachycardia?

15. Does anyone in your family have a heart problem, pacemaker, or implanted defibrillator?

16. Has anyone in your family had unexplained fainting, unexplained seizures, or near drowning?

BONE AND JOINT QUESTIONS Yes No17. Have you ever had an injury to a bone, muscle, ligament, or tendon

that caused you to miss a practice or a game?

18. Have you ever had any broken or fractured bones or dislocated joints?

19. Have you ever had an injury that required x-rays, MRI, CT scan, injections, therapy, a brace, a cast, or crutches?

20. Have you ever had a stress fracture?

21. Have you ever been told that you have or have you had an x-ray for neck instability or atlantoaxial instability? (Down syndrome or dwarfism)

22. Do you regularly use a brace, orthotics, or other assistive device?

23. Do you have a bone, muscle, or joint injury that bothers you?

24. Do any of your joints become painful, swollen, feel warm, or look red?

25. Do you have any history of juvenile arthritis or connective tissue disease?

MEDICAL QUESTIONS Yes No26. Do you cough, wheeze, or have difficulty breathing during or

after exercise?

27. Have you ever used an inhaler or taken asthma medicine?

28. Is there anyone in your family who has asthma?

29. Were you born without or are you missing a kidney, an eye, a testicle (males), your spleen, or any other organ?

30. Do you have groin pain or a painful bulge or hernia in the groin area?

31. Have you had infectious mononucleosis (mono) within the last month?

32. Do you have any rashes, pressure sores, or other skin problems?

33. Have you had a herpes or MRSA skin infection?

34. Have you ever had a head injury or concussion?

35. Have you ever had a hit or blow to the head that caused confusion, prolonged headache, or memory problems?

36. Do you have a history of seizure disorder?

37. Do you have headaches with exercise?

38. Have you ever had numbness, tingling, or weakness in your arms or legs after being hit or falling?

39. Have you ever been unable to move your arms or legs after being hit or falling?

40. Have you ever become ill while exercising in the heat?

41. Do you get frequent muscle cramps when exercising?

42. Do you or someone in your family have sickle cell trait or disease?

43. Have you had any problems with your eyes or vision?

44. Have you had any eye injuries?

45. Do you wear glasses or contact lenses?

46. Do you wear protective eyewear, such as goggles or a face shield?

47. Do you worry about your weight?

48. Are you trying to or has anyone recommended that you gain or lose weight?

49. Are you on a special diet or do you avoid certain types of foods?

50. Have you ever had an eating disorder?

51. Do you have any concerns that you would like to discuss with a doctor?

FEMALES ONLY52. Have you ever had a menstrual period?

53. How old were you when you had your first menstrual period?

54. How many periods have you had in the last 12 months?

Explain “yes” answers here

I hereby state that, to the best of my knowledge, my answers to the above questions are complete and correct.

Signature of athlete __________________________________________ Signature of parent/guardian ____________________________________________________________ Date _____________________

©2010 American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine. Permission is granted to reprint for noncommercial, educational purposes with acknowledgment.HE0503 9-2681/0410

■ Preparticipation Physical Evaluation THE ATHLETE WITH SPECIAL NEEDS: SUPPLEMENTAL HISTORY FORM

Date of Exam ___________________________________________________________________________________________________________________

Name __________________________________________________________________________________ Date of birth __________________________

Sex _______ Age __________ Grade _____________ School _____________________________ Sport(s) __________________________________

1. Type of disability

2. Date of disability

3. Classification (if available)

4. Cause of disability (birth, disease, accident/trauma, other)

5. List the sports you are interested in playing

Yes No6. Do you regularly use a brace, assistive device, or prosthetic?

7. Do you use any special brace or assistive device for sports?

8. Do you have any rashes, pressure sores, or any other skin problems?

9. Do you have a hearing loss? Do you use a hearing aid?

10. Do you have a visual impairment?

11. Do you use any special devices for bowel or bladder function?

12. Do you have burning or discomfort when urinating?

13. Have you had autonomic dysreflexia?

14. Have you ever been diagnosed with a heat-related (hyperthermia) or cold-related (hypothermia) illness?

15. Do you have muscle spasticity?

16. Do you have frequent seizures that cannot be controlled by medication?

Explain “yes” answers here

Please indicate if you have ever had any of the following.

Yes NoAtlantoaxial instability

X-ray evaluation for atlantoaxial instability

Dislocated joints (more than one)

Easy bleeding

Enlarged spleen

Hepatitis

Osteopenia or osteoporosis

Difficulty controlling bowel

Difficulty controlling bladder

Numbness or tingling in arms or hands

Numbness or tingling in legs or feet

Weakness in arms or hands

Weakness in legs or feet

Recent change in coordination

Recent change in ability to walk

Spina bifida

Latex allergy

Explain “yes” answers here

I hereby state that, to the best of my knowledge, my answers to the above questions are complete and correct.

Signature of athlete __________________________________________ Signature of parent/guardian __________________________________________________________ Date _____________________

©2010 American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine. Permission is granted to reprint for noncommercial, educational purposes with acknowledgment.

■ Preparticipation Physical Evaluation PHYSICAL EXAMINATION FORM

Name __________________________________________________________________________________ Date of birth __________________________

PHYSICIAN REMINDERS1. Consider additional questions on more sensitive issues

• Do you feel stressed out or under a lot of pressure?• Do you ever feel sad, hopeless, depressed, or anxious?• Do you feel safe at your home or residence?• Have you ever tried cigarettes, chewing tobacco, snuff, or dip?• During the past 30 days, did you use chewing tobacco, snuff, or dip?• Do you drink alcohol or use any other drugs?• Have you ever taken anabolic steroids or used any other performance supplement?• Have you ever taken any supplements to help you gain or lose weight or improve your performance?• Do you wear a seat belt, use a helmet, and use condoms?

2. Consider reviewing questions on cardiovascular symptoms (questions 5–14).

EXAMINATIONHeight Weight � Male � Female

BP / ( / ) Pulse Vision R 20/ L 20/ Corrected � Y � NMEDICAL NORMAL ABNORMAL FINDINGSAppearance• Marfan stigmata (kyphoscoliosis, high-arched palate, pectus excavatum, arachnodactyly,

arm span > height, hyperlaxity, myopia, MVP, aortic insufficiency)Eyes/ears/nose/throat• Pupils equal• HearingLymph nodesHeart a

• Murmurs (auscultation standing, supine, +/- Valsalva)• Location of point of maximal impulse (PMI)Pulses• Simultaneous femoral and radial pulsesLungsAbdomenGenitourinary (males only)b

Skin• HSV, lesions suggestive of MRSA, tinea corporisNeurologic c

MUSCULOSKELETALNeckBackShoulder/armElbow/forearmWrist/hand/fingersHip/thighKneeLeg/ankleFoot/toesFunctional• Duck-walk, single leg hop

aConsider ECG, echocardiogram, and referral to cardiology for abnormal cardiac history or exam.bConsider GU exam if in private setting. Having third party present is recommended. cConsider cognitive evaluation or baseline neuropsychiatric testing if a history of significant concussion.

��Cleared for all sports without restriction

��Cleared for all sports without restriction with recommendations for further evaluation or treatment for _________________________________________________________________

____________________________________________________________________________________________________________________________________________

��Not cleared

��Pending further evaluation

��For any sports

��For certain sports _____________________________________________________________________________________________________________________

Reason ___________________________________________________________________________________________________________________________

Recommendations _________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________________

I have examined the above-named student and completed the preparticipation physical evaluation. The athlete does not present apparent clinical contraindications to practice and participate in the sport(s) as outlined above. A copy of the physical exam is on record in my office and can be made available to the school at the request of the parents. If condi-tions arise after the athlete has been cleared for participation, the physician may rescind the clearance until the problem is resolved and the potential consequences are completely explained to the athlete (and parents/guardians).

Name of physician (print/type) _____________________________________________________________________________________________________ Date ________________

Address ___________________________________________________________________________________________________________ Phone _________________________

Signature of physician _______________________________________________________________________________________________________________________, MD or DO

©2010 American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine. Permission is granted to reprint for noncommercial, educational purposes with acknowledgment.HE0503 9-2681/0410

■ Preparticipation Physical Evaluation CLEARANCE FORM

Name ___ ____________________________________________________ Sex ��M ��F Age _________________ Date of birth _________________

��Cleared for all sports without restriction

��Cleared for all sports without restriction with recommendations for further evaluation or treatment for _______________________________________________

___________________________________________________________________________________________________________________________

��Not cleared

��Pending further evaluation

��For any sports

��For certain sports _____________________________________________________________________________________________________

Reason ___________________________________________________________________________________________________________

Recommendations _______________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

I have examined the above-named student and completed the preparticipation physical evaluation. The athlete does not present apparent clinical contraindications to practice and participate in the sport(s) as outlined above. A copy of the physical exam is on record in my office and can be made available to the school at the request of the parents. If conditions arise after the athlete has been cleared for participation, the physician may rescind the clearance until the problem is resolved and the potential consequences are completely explained to the athlete (and parents/guardians).

Name of physician (print/type) ___________________________________________________________________________________ Date ________________

Address _________________________________________________________________________________________ Phone _________________________

Signature of physician _____________________________________________________________________________________________________, MD or DO

EMERGENCY INFORMATION

Allergies ______________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

Other information _______________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

©2010 American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine. Permission is granted to reprint for noncommercial, educational purposes with acknowledgment.

7/1/15: Student Support *IFCB&3* Page 1 of 1

Form IFCB-3 Empowering Dreams for the Future

“BLANKET”*PERMISSION*TO*PARTICIPATE*IN*A*SERIES*OF*SCHOOL4SPONSORED*FIELD*TRIPS

**

Student Information

Student.

Name:.

.....

. .Date.of.Birth:.

.....

.

Address:.

.....

. .Home.Phone:.

.....

.

In.case.of.emergency,.

notify:.

.....

. .Phone:.

.....

.

Insurance Information Company.Providing.

Insurance:.

.....

. .Policy.Number:.

.....

.

Name.of.Insured:.

.....

. .Group.Number:.

.....

.

Medical Information Does.the.student.need.to.take.medication?.. Yes.. No...If.so,.what.

medication?.

.....

.

Special medical conditions:.

.....

.

Allergies? Yes No If yes, please identify allergy: Medication Food Stinging Insects Other. .

Please identify:

.....

.

Dietary.

Restrictions:.

.....

.

Release

I hereby request that (Student’s Name-PLEASE PRINT): ________________________________________ be allowed to participate in athletic team, band, orchestra, chorus, and/or any series of field trips related to one particular area of study or activity. I understand that transportation may or may not be provided by the Cobb County School District (District). In the event transportation is not provided by the District, transportation will be the student’s responsibility.

Detailed trip information, including destination, date, time of departure, time of return, purpose, and supervision, should be given in writing to the parents at least two (2) weeks prior to each trip in the series.

The District does have an indemnity plan pursuant to O.C.G.A. § 20-2-1090 that may or may not apply relative to the trip. Even if the plan covers some or all of the trip, the coverage amounts may not cover all injuries. I understand that as a parent I have the option of, and am encouraged to, purchase student insurance coverage either through the student accident insurance offered by the District or through my own insurance carrier. .

If.any.emergency.medical.procedures.or.treatment.are.required.during.the.trip,.I.consent.to.the.trip.supervisor(s).

taking,.arranging.for.or.consenting.to.the.procedures.or.treatment.in.his/her.or.their.discretion...

I.agree.to.release,.indemnify,.and.hold.harmless.or.reimburse.the.Cobb.County.School.District.(District),.its.Board.

of.Education,.and.its.members,.employees,.agents,.representatives,.successors.or.assignees,.as.well.as.its.

approved..adult.trip.supervisors.(“District.Indemnitees”).from.and.forever.promise.not.to.sue.them.on.any.and.all.

claims,.demands,.rights,.causes.of.action,.liabilities,.losses,.damages,.costs.and.expenses.(including.reasonable.

attorneys’.fees),.whether.known.or.unknown,.that.I,.any.other.parent.or.guardian.of.the.above&named.student,.the.

student.or.any.other.successor.or.assignee.may.have.or.may.allege.to.have.against.the.District.Indemnitees.or.

which.may.be.brought.against.the.District.Indemnitees.arising.out.of.or.in.any.manner.relating.to.the.student’s.

participation.in.the.field.trips,.including.but.not.limited.any.losses,.damages.or.injuries.or.to.the.rendering.of.

emergency.medical.procedures.or.treatment...

NOTE: This form must be signed by student if the student is 18 years of age or older.

Name of Parent/Guardian (PLEASE PRINT) Signature of Parent/Guardian Date

STUDENT/PARENT CONCUSSION AWARENESS FORM SCHOOL: __________________________________________________________________________ DANGERS OF CONCUSSION Concussions at all levels of sports have received a great deal of attention and a state law has been passed to address this issue. Adolescent athletes are particularly vulnerable to the effects of concussion. Once considered little more than a minor “ding” to the head, it is now understood that a concussion has the potential to result in death, or changes in brain function (either short-term or long-term). A concussion is a brain injury that results in a temporary disruption of normal brain function. A concussion occurs when the brain is violently rocked back and forth or twisted inside the skull as a result of a blow to the head or body. Continued participation in any sport following a concussion can lead to worsening concussion symptoms, as well as increased risk for further injury to the brain, and even death. Player and parental education in this area is crucial – that is the reason for this document. Refer to it regularly. This form must be signed by a parent or guardian of each student who wishes to participate in GHSA athletics. One copy needs to be returned to the school, and one retained at home. COMMON SIGNS AND SYMPTOMS OF CONCUSSION

Headache, dizziness, poor balance, moves clumsily, reduced energy level/tiredness Nausea or vomiting Blurred vision, sensitivity to light and sounds Fogginess of memory, difficulty concentrating, slowed thought processes, confused about surroundings or game

assignments Unexplained changes in behavior and personality Loss of consciousness (NOTE: This does not occur in all concussion episodes.)

BY-LAW 2.68: GHSA CONCUSSION POLICY: In accordance with Georgia law and national playing rules published by the National Federation of State High School Associations, any athlete who exhibits signs, symptoms, or behaviors consistent with a concussion shall be immediately removed from the practice or contest and shall not return to play until an appropriate health care professional has determined that no concussion has occurred. (NOTE: An appropriate health care professional may include, licensed physician (MD/DO) or another licensed individual under the supervision of a licensed physician, such as a nurse practitioner, physician assistant, or certified athletic trainer who has received training in concussion evaluation and management.

a) No athlete is allowed to return to a game or a practice on the same day that a concussion (a) has been diagnosed, OR (b) cannot be ruled out.

b) Any athlete diagnosed with a concussion shall be cleared medically by an appropriate health care professional prior to resuming participation in any future practice or contest. The formulation of a gradual return to play protocol shall be a part of the medical clearance.

c) It is mandatory that every coach in each GHSA sport participate in a free, online course on concussion management prepared by the NFHS and available at www.nfhslearn.com at least every two years – beginning with the 2013-2014 school year.

d) Each school will be responsible for monitoring the participation of its coaches in the concussion management course, and shall keep a record of those who participate.

I HAVE READ THIS FORM AND I UNDERSTAND THE FACTS PRESENTED IN IT. SIGNED: ______________________________ _______________________________ (Student) (Parent or Guardian) DATE: __________________________

Page 1 of 4

DISTRICT ADMINISTRATIVE RULE

IDF-R Interscholastic Activities 7/1/15 RATIONALE/OBJECTIVE:   Participation in interscholastic/extracurricular (extracurricular) activities in Cobb County School District (District) schools is a privilege. Students participating in these activities are considered to be school leaders and role models who represent their school and more importantly, depict its character. With leadership comes additional responsibility and student participants must adhere to high standards of conduct. When students violate these standards of conduct, the District may withdraw the privilege of participation in interscholastic/extracurricular activities. The purpose of this code of conduct is to establish a minimum expectation of behavior. RULE: A. PROCEDURES:

1. Time in Effect: Except as specifically provided, the following behavioral expectations and prohibitions apply 365 days a year, 24 hours a day, in and out of the specific extracurricular season, on or off school grounds, and through the use of school or outside technology resources.

2. Parental/Self Reporting of Law Enforcement: Parents/guardians and/or students must report any charges against or arrest of a student or student behavior in which law enforcement is involved, to their high school administration or coach within two weeks (14 calendar days) of the arrest or behavior. The two week time frame includes weekends, school holidays and summer vacation. Failure to report arrest, charges or behavior may result in additional consequences which may include, but is not limited to, doubling of the student’s consequences for the behavior in question.

3. Provisions: a. Sponsors/Coaches should investigate policy violations and report to the school

administration. The Principal or designee should make all determinations of penalties, in consultation with the coaches, sponsors and the District Athletic Director, as appropriate.

b. Unless otherwise specified, periods of suspension from activities does not include preseason workouts and other preseason activities. Such student’s ability to participate in preseason activities will be determined by the Principal or designee in consultation with the coach. During the student’s period of suspension the student cannot have contact with the team during any team activities.

c. Students cannot attempt to evade the intent of the Rule by joining a new sport specifically to allow their suspension days to run their course. If a student athlete participates in a sport that he/she had not been previously involved with, he/she must complete the season of the new sport in good standing in order for the suspension days to count.

d. Transferring from one District school to another does not relieve the student from the consequences for a violation of this Rule. Should a student choose to transfer outside of the District, the designated school administrator or the school athletic director will contact the new school to inform them of the violation and the resulting penalty. The District may also honor the activity consequences from other private or public school systems.

4. Notification: a. Elementary/Middle Schools:

In addition to providing students with copies of the appropriate Student Code of Conduct (Administrative Rules JCDA-R [Elementary], JCDA-R [Middle]), elementary

Page 2 of 4

and middle schools should make participants in extracurricular activities aware of this Administrative Rule.

b. High Schools: In addition to providing students with copies of the appropriate Student Code of Conduct (Administrative Rule JCDA-R [High]), each high school should provide written notification of this Administrative Rule to all participants in extracurricular activities.

B. ALCOHOL/ILLEGAL DRUGS/INHALANTS: The District believes very strongly that use, possession, selling or buying over the counter drugs or products to get high; alcohol; illegal drugs; or prescription drugs in an unauthorized manner at any time is an offense. Such use, possession or distribution by extracurricular participants is banned. All misdemeanor driving under the influence (DUI) offenses will be dealt with according to this section. All felony DUI offenses will be dealt with under Section D, below. Offenses are cumulative at the high school level. x 1st Offense:

o Suspension from extracurricular activities, including practice and regular season, a minimum twenty-five (25) calendar days; plus

o Suspension from a minimum of 30% of the regular season contests/performances; plus

o Student must complete the GRIP (Gaining Results in Intervention and Prevention Program) which consists of one four hour Saturday session attended by the student and the parent, or another comparable program. If the student cannot attend the program until after the suspension is lifted, they must still attend the program in order to be eligible to compete in their next extracurricular/athletic season. Failure to attend or complete the program as required may result in continued extracurricular/athletic ineligibility beyond the initial suspension.

o If offense is during the off season, the first offense suspension will begin on the GHSA start date for the next season with which the recognized athlete is affiliated.

o If the student has not completed his suspension at the end of the season, the remaining days will be completed at the beginning of the next affiliated GHSA activity.

x 2nd Offense: Suspension from extracurricular activities for a minimum of one calendar year. The student will not be permitted to participate in preseason activities or practice.

x 3rd Offense: Permanent suspension from extracurricular activities, including preseason activities and practices.

C. TOBACCO [IN-SEASON USE]: x 1st Offense:

Suspension from all extracurricular activities for two (2) school days/ x 2nd Offense:

Suspension from all extracurricular activities for five (5) school days and must sit out 10% of games/matches/performances/competitions.

x 3rd Offense: Suspension from all extracurricular activities for ten (10) school days and must sit out 20% of games/matches/performances/competitions.

x 4th Offense and Subsequent Offense: Suspension from all extracurricular activities for ninety (90) calendar days.

D. FELONY: 1. Guidelines:

a. A student who is arrested for, indicted for, convicted of, or charged with a felony or act that would constitute a felony if committed by an adult shall be automatically suspended from interscholastic/extracurricular activities;

b. Students will not be permitted to participate in preseason activities; c. DUI:

All felony DUI offenses will be dealt with according to this section. 2. Duration:

Page 3 of 4

a. The student shall remain suspended from extracurricular activities until: (1) The charges are completely dismissed; (2) The charges are reduced to a misdemeanor in which case the student may be

subject to penalties outlined in Section E, below, or Section B, for alcohol offenses; (3) The student is found not guilty; or (4) The student serves his/her consequences as outlined below.

b. Once the student successfully completes the consequences assigned by the judge or agreed to by the student, including probation or diversion, the student may be permitted to participate in extracurricular activities. Evidence that the probation period has expired, fines have been paid and/or community service has been completed is required.

c. If a student has been arrested or charged with an offense, but the matter has been expunged, sealed, removed from a student’s record, treated as a “first offender” action, or the behavior has not been prosecuted (nolle prosequi), that student may present or obtain documentation as required by the school to determine the circumstances of the matter and appropriate eligibility consequences, as determined at the discretion of school administration. Such incidents will be reviewed on an individualized basis and a legal determination in the matter may not be sufficient to change the student’s consequences.

E. MISDEMEANORS: 1. A student who is arrested for, charged with, or found guilty of a misdemeanor shall receive

consequences as outlined below. However, minor offenses that result in fines alone may be dealt with as a violation of Section F(7) below.

o 1st and Subsequent Offenses: o Minimum suspension from extracurricular activities for one (1) school day up to a

maximum of permanent suspension from extracurricular activities. 2. Drug/Alcohol/DUI:

Any student who is accused of a misdemeanor alcohol/drug offense or a misdemeanor DUI will receive consequences as outlined in Section B above.

3. If the student produces proof that the charges are completely dismissed or the student is found not guilty, these consequences may be lifted. If a student has been arrested or charged with an offense, but the matter has been expunged, sealed, removed from a student’s record, treated as a “first offender” action, or the behavior has not been prosecuted (nolle prosequi), that student may present or obtain documentation as required by the school to determine the circumstances of the matter and appropriate eligibility consequences, as determined at the discretion of school administration. Such incidents will be reviewed on an individualized basis and a legal determination in the matter may not be sufficient to change the student’s consequences.

F. OTHER OFFENSES: A student who commits the following offenses may be suspended or permanently dismissed from the team or activity. The head coach in conjunction with the school administration will determine consequences for the following: 1. Hazing:

School clubs and student organizations shall not use hazing or degradation of individual dignity (Administrative Rule JHC-R [School Clubs/Organizations and Student Organizations]);

2. Missing practice, rehearsal or activities (unless excused by the coach, teacher, or sponsor);

3. Truancy and/or skipping classes; 4. Acting in an unsportsmanlike manner when representing the school; 5. Violating curfew as established by the coach; 6. Any act at school or away from school, which results in any discipline by school

administration; or 7. Any act at school or away from school which, in the opinion of the Principal reflects in a

negative manner on the school, athletic program, or activity. Adopted: 9/28/00; 8/11/04

Page 4 of 4

Reclassified an Administrative Rule: 9/1/04 Revised: 8/10/05; 6/10/09; 4/14/10 Revised and re-coded: 1/7/13 (Previously coded as Administrative Rule JICDD) Revised: 7/1/13; 7/1/15 Legal Reference O.C.G.A. 20-17-0002 Interstate Compact on Educational Opportunity for Military Children O.C.G.A. 20-02-0160 Determination of enrollment; determination of funding O.C.G.A. 20-02-0315 Gender equity in sports O.C.G.A. 20-02-0316 Athletic association defined; high school athletics O.C.G.A. 20-02-0411 School fund kept separate; use of funds; separation of school taxes; investments O.C.G.A. 20-02-0086 Operation of school councils; training; membership; management; roles and responsibilities Rule 160-5-1-.18 Competitive Interscholastic Activities in Grades 6-12 20 USC 1681 Title IX of the Education Amendments of 1972

CCSD 2015-16 Student/Parent Athletic Handbook

Table of Contents Athletic Code of Conduct............................................................................................................................................2

GHSA Eligibility ...........................................................................................................................................................6

Extreme Weather Conditions .....................................................................................................................................7

Transportation ............................................................................................................................................................7

Concussion Management ...........................................................................................................................................8

Student-Athlete Social Media Guidelines ...................................................................................................................8

Parents and Sportsmanship ........................................................................................................................................9

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Athletic Code of Conduct

DISTRICT ADMINISTRATIVE RULE IDF-R Interscholastic Activities 7/1/15 RATIONALE/OBJECTIVE: Participation in interscholastic/extracurricular (extracurricular) activities in Cobb County School District (District) schools is a privilege. Students participating in these activities are considered to be school leaders and role models who represent their school and more importantly, depict its character. With leadership comes additional responsibility and student participants must adhere to high standards of conduct. When students violate these standards of conduct, the District may withdraw the privilege of participation in interscholastic/extracurricular activities. The purpose of this code of conduct is to establish a minimum expectation of behavior. RULE: A. PROCEDURES: 1. Time in Effect: Except as specifically provided, the following behavioral expectations and prohibitions apply 365 days a year, 24 hours a day, in and out of the specific extracurricular season, on or off school grounds, and through the use of school or outside technology resources. 2. Parental/Self Reporting of Law Enforcement: Parents/guardians and/or students must report any charges against or arrest of a student or student behavior in which law enforcement is involved, to their high school administration or coach within two weeks (14 calendar days) of the arrest or behavior. The two week time frame includes weekends, school holidays and summer vacation. Failure to report arrest, charges or behavior may result in additional consequences which may include, but is not limited to, doubling of the student’s consequences for the behavior in question. 3. Provisions: a. Sponsors/Coaches should investigate policy violations and report to the school administration. The Principal or designee should make all determinations of penalties, in consultation with the coaches, sponsors and the District Athletic Director, as appropriate. b. Unless otherwise specified, periods of suspension from activities does not include preseason workouts and other preseason activities. Such student’s ability to participate in preseason activities will be determined by the Principal or designee in consultation with the coach. During the student’s period of suspension the student cannot have contact with the team during any team activities. c. Students cannot attempt to evade the intent of the Rule by joining a new sport specifically to allow their suspension days to run their course. If a student athlete participates in a sport that he/she had not been previously involved with, he/she must complete the season of the new sport in good standing in order for the suspension days to count. d. Transferring from one District school to another does not relieve the student from the consequences for a violation of this Rule. Should a student choose to transfer outside of the District, the designated school administrator or the school athletic director will contact the new school to inform them of the violation and the resulting penalty. The District may also honor the activity consequences from other private or public school systems. 4. Notification: a. Elementary/Middle Schools: In addition to providing students with copies of the appropriate Student Code of Conduct (Administrative Rules JCDA-R [Elementary], JCDA-R [Middle]), elementary and middle schools should make participants in extracurricular activities aware of this Administrative Rule.

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b. High Schools: In addition to providing students with copies of the appropriate Student Code of Conduct (Administrative Rule JCDA-R [High]), each high school should provide written notification of this Administrative Rule to all participants in extracurricular activities. B. ALCOHOL/ILLEGAL DRUGS/INHALANTS: The District believes very strongly that use, possession, selling or buying over the counter drugs or products to get high; alcohol; illegal drugs; or prescription drugs in an unauthorized manner at any time is an offense. Such use, possession or distribution by extracurricular participants is banned. All misdemeanor driving under the influence (DUI) offenses will be dealt with according to this section. All felony DUI offenses will be dealt with under Section D, below. Offenses are cumulative at the high school level. � 1st Offense: o Suspension from extracurricular activities, including practice and regular season, a minimum twenty-five (25) calendar days; plus o Suspension from a minimum of 30% of the regular season contests/performances; plus o Student must complete the GRIP (Gaining Results in Intervention and Prevention Program) which consists of one four hour Saturday session attended by the student and the parent, or another comparable program. If the student cannot attend the program until after the suspension is lifted, they must still attend the program in order to be eligible to compete in their next extracurricular/athletic season. Failure to attend or complete the program as required may result in continued extracurricular/athletic ineligibility beyond the initial suspension. o If offense is during the off season, the first offense suspension will begin on the GHSA start date for the next season with which the recognized athlete is affiliated. o If the student has not completed his suspension at the end of the season, the remaining days will be completed at the beginning of the next affiliated GHSA activity. � 2nd Offense: Suspension from extracurricular activities for a minimum of one calendar year. The student will not be permitted to participate in preseason activities or practice. � 3rd Offense: Permanent suspension from extracurricular activities, including preseason activities and practices. C. TOBACCO [IN-SEASON USE]: � 1st Offense: Suspension from all extracurricular activities for two (2) school days/ � 2nd Offense: Suspension from all extracurricular activities for five (5) school days and must sit out 10% of games/matches/performances/competitions. � 3rd Offense: Suspension from all extracurricular activities for ten (10) school days and must sit out 20% of games/matches/performances/competitions. � 4th Offense and Subsequent Offense: Suspension from all extracurricular activities for ninety (90) calendar days. D. FELONY: 1. Guidelines: a. A student who is arrested for, indicted for, convicted of, or charged with a felony or act that would constitute a felony if committed by an adult shall be automatically suspended from interscholastic/extracurricular activities; b. Students will not be permitted to participate in preseason activities;

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c. DUI: All felony DUI offenses will be dealt with according to this section. 2. Duration: a. The student shall remain suspended from extracurricular activities until: (1) The charges are completely dismissed; (2) The charges are reduced to a misdemeanor in which case the student may be subject to penalties outlined in Section E, below, or Section B, for alcohol offenses; (3) The student is found not guilty; or (4) The student serves his/her consequences as outlined below. b. Once the student successfully completes the consequences assigned by the judge or agreed to by the student, including probation or diversion, the student may be permitted to participate in extracurricular activities. Evidence that the probation period has expired, fines have been paid and/or community service has been completed is required. c. If a student has been arrested or charged with an offense, but the matter has been expunged, sealed, removed from a student’s record, treated as a “first offender” action, or the behavior has not been prosecuted (nolle prosequi), that student may present or obtain documentation as required by the school to determine the circumstances of the matter and appropriate eligibility consequences, as determined at the discretion of school administration. Such incidents will be reviewed on an individualized basis and a legal determination in the matter may not be sufficient to change the student’s consequences. E. MISDEMEANORS: 1. A student who is arrested for, charged with, or found guilty of a misdemeanor shall receive consequences as outlined below. However, minor offenses that result in fines alone may be dealt with as a violation of Section F(7) below. o 1st and Subsequent Offenses: o Minimum suspension from extracurricular activities for one (1) school day up to a maximum of permanent suspension from extracurricular activities. 2. Drug/Alcohol/DUI: Any student who is accused of a misdemeanor alcohol/drug offense or a misdemeanor DUI will receive consequences as outlined in Section B above. 3. If the student produces proof that the charges are completely dismissed or the student is found not guilty, these consequences may be lifted. If a student has been arrested or charged with an offense, but the matter has been expunged, sealed, removed from a student’s record, treated as a “first offender” action, or the behavior has not been prosecuted (nolle prosequi), that student may present or obtain documentation as required by the school to determine the circumstances of the matter and appropriate eligibility consequences, as determined at the discretion of school administration. Such incidents will be reviewed on an individualized basis and a legal determination in the matter may not be sufficient to change the student’s consequences. F. OTHER OFFENSES: A student who commits the following offenses may be suspended or permanently dismissed from the team or activity. The head coach in conjunction with the school administration will determine consequences for the following: 1. Hazing: School clubs and student organizations shall not use hazing or degradation of individual dignity (Administrative Rule JHC-R [School Clubs/Organizations and Student Organizations]); 2. Missing practice, rehearsal or activities (unless excused by the coach, teacher, or sponsor); 3. Truancy and/or skipping classes; 4. Acting in an unsportsmanlike manner when representing the school; 5. Violating curfew as established by the coach;

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6. Any act at school or away from school, which results in any discipline by school administration; or 7. Any act at school or away from school which, in the opinion of the Principal reflects in a negative manner on the school, athletic program, or activity. Adopted: 9/28/00; 8/11/04 Reclassified an Administrative Rule: 9/1/04 Revised: 8/10/05; 6/10/09; 4/14/10 Revised and re-coded: 1/7/13 (Previously coded as Administrative Rule JICDD) Revised: 7/1/13; 7/1/15 Legal Reference O.C.G.A. 20-17-0002 Interstate Compact on Educational Opportunity for Military Children O.C.G.A. 20-02-0160 Determination of enrollment; determination of funding O.C.G.A. 20-02-0315 Gender equity in sports O.C.G.A. 20-02-0316 Athletic association defined; high school athletics O.C.G.A. 20-02-0411 School fund kept separate; use of funds; separation of school taxes; investments O.C.G.A. 20-02-0086 Operation of school councils; training; membership; management; roles and responsibilities Rule 160-5-1-.18 Competitive Interscholastic Activities in Grades 6-12

20 USC 1681 Title IX of the Education Amendments of 1972

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GHSA Eligibility

1.21 To be eligible to participate and/or try-out for a sport or activity, a student must be enrolled full

time in grades 9-12 inclusive at the school seeking eligibility for that student.

(a) Enrollment is defined as follows:

(1) Fall Semester: when the student participates in a practice or contest before classes

begin, or the student attends classes.

(2) Spring Semester: when the student attends classes.

(b) The student must be in regular attendance.

(c) The student must be taking courses that total at least 2.5 Units that count toward

graduation.

1.30 – AGE to be eligible to participate in interscholastic activities, a student must not have reached his

19th birthday prior to May 1st, preceding his year of participation.

1.41 Students must have a certificate of an annual physical examination on file at the school prior to

participating in any athletic try-outs, practices, voluntary workouts or games that indicate the students

are physically approved for participation.

(a) Physical examinations will be good for twelve (12) months from the date of the exam.

EXCEPTION: Any physical examination taken on or after April 1 in the preceding year will be

accepted for the entire next GHSA school year.

(b) The physical exam must be conducted by a licensed medical physician, doctor of

Osteopathic medicine, nurse practitioner or a physician’s assistant.

(c) The exam must be signed by an M.D., D.O., or by a Physician’s Assistant, or an Advance

Practice Nurse who has been delegated that task by an M.D., or D.O.

(d) The GHSA requires that member schools use the latest edition of the pre-participation

physical evaluation form approved by the American Academy of Pediatrics, et. al., found on the

GHSA website.

1.51 To be eligible to participate, practice, and/or try out in interscholastic activities, a student must be

academically eligible. A student is required to pass classes that carry at least 2.5 Units counting toward

graduation the semester immediately preceding participation.

1.53 Students must accumulate units towards graduation according to the following criteria:

(a) First-year students (entering 9th grade) are eligible academically. Second semester first-year

students must have passed courses carrying at least 2.5 units the previous semester in order to

participate.

(b) Second-year students must have accumulated five (5) total units in the first year, AND

passed courses carrying at least 2.5 units in the previous semester.

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(c) Third-year students must have accumulated eleven (11) units in the first and second years,

AND passed courses carrying at least 2.5 units in the previous semester.

(d) Fourth-year students must have accumulated seventeen (17) units in the first three years,

AND passed courses carrying at least 2.5 units in the previous semester.

(e) Students may accumulate the required units for participation during the school year and

eligibility will be reinstated at the beginning of the next semester.

1.62 A transfer student who has established eligibility at a former school in grades 9-12 shall be

immediately eligible at the new school if:

(a) The student moved simultaneously with the entire parental unit or persons he/she resided

with at the former school, and the student and parent(s) or persons residing with the student

live in the service area of the new school. This is known as a “bona fide move.”

For more information concerning GHSA eligibility please visit www.GHSA.net/constitution

Extreme Weather Conditions Hot Humid Weather

Schools must follow the statewide policy for conducting practices and voluntary conditioning workouts in all sports during times of extremely high heat and/or humidity that will be signed by each head coach at the beginning of each season and distributed to all players and their parents or guardians. For more information please see GHSA.net/practice-policy-heat-and-humidity or

www.cobbk12.org/centraloffice/athletics/

Extreme Cold Temperatures

The local school principal, or designee, will make the final decision as to whether outdoor practice will be allowed. Any game cancellations due to extremely cold weather will be the responsibility of the two competing team’s administrations.

Transportation Transportation may or may not be provided by the Cobb County School District. In the event

transportation is not provided by CCSD, transportation will be the student’s responsibility. Student

drivers should not drive other students to/from practices/competitions. When parents and students

volunteer to drive their own vehicles on school system business, such as sporting events or other

school activities, the Cobb County School District does not provide liability insurance or medical

insurance; the volunteer is the liable party.

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Concussion Management Concussions at all levels of sports have received a great deal of attention in the past few years.

Adolescent athletes are particularly vulnerable to the effects of concussions. Thus, for the health of

our student athletes, the Cobb County School District has developed guidelines for the management of

concussions in conjunction with the GHSA, NFHS and the State of Georgia. Each school will distribute to

every athlete and his/her parent/guardian an information sheet that includes: the dangers of

concussion injuries, the signs/symptoms of concussion, and the concussion management protocol. This

sheet must be signed by the parent/guardian of each athlete and returned to the school.

For more information see cobbk12.org/centraloffice/athletics

Student-Athlete Social Media Guidelines

Given consideration to accessibility and use of social media in today’s society, the Cobb County Schools

Athletic Department is recommending guidelines to assist our athletes in developing the skills needed

to make positive decisions while using social media outlets. The need to understand what is social

media appropriate, and what is not is paramount, as many employers and colleges now view potential

candidate’s social media activities before asking them to join their organization. This is specifically

evident in collegiate athletics where students have had scholarships revoked, served suspensions, and

are occasionally removed from teams.

The below guidelines should be used to assist student athletes with deciding what to post on social

media outlets. They provide a set of parameters to stay within when deciding to post statements

and photos. Coaches will assist by being a resource athletes can turn to for advice.

Guidelines:

1. Social Media use should not violate the CCSD Student Code of Conduct, JCDA (High).

2. Post should not be demeaning or disrespectful to teammates, coaches, peers or other

institutions.

3. Post should not contain profane, vulgar, obscene or offensive language.

4. Photos should not contain nudity, be vulgar, obscene or offensive in nature.

5. Photos or written post should not contain or reference illegal acts.

6. Post should not cast a negative image or negative perception of the athlete, team, or school.

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Parents and Sportsmanship When your son/daughter enlisted in one of our interscholastic athletic activity programs, he/she has

committed to certain responsibilities and obligations. Likewise, we feel you have committed

yourselves to certain responsibilities and obligations. We would encourage you to join your school’s

Booster Club(s) to help provide the financial and volunteer support essential to your school’s

interscholastic athletic activities program, and we would like to take this opportunity to acquaint

you with expectations of parental involvement and sportsmanship.

Parent/guardian expectations:

1. Stress the values derived from playing the game fairly.

2. Show courtesy and respect to visiting teams, visiting parents/fans, and officials.

3. Respect the integrity and judgment of game officials and accept their decisions without

showing inappropriate emotions.

4. Do not confront coaches at the game – arrange another time to speak to them or the

Athletic Director.

5. Do not use profane language or gestures.

6. Help your child set realistic goals. The primary value of athletics is the opportunity for self-

development allowing them to develop life-long values and self-esteem.

7. Remember an athletic contest is only a game – not a matter of life or death for a player,

coach, school official, fan, community, state or nation.

8. Parents and supporters understand that inappropriate behavior may result in criminal

trespass charges which would prevent them from coming back on campus to watch their

child’s activities.

Let the players play Let the coaches coach

Let the officials officiate Let the fans cheer positively!

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