METROLINA CHRISTIAN ACADEMY PARENT/STUDENT ATHLETE COOPERATION FORM

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1 PARENT/STUDENT ATHLETE COOPERATION FORM Whatsoever thy hand findeth to do, do it with all thy might. -- Ecclesiastes 9:10 Purpose Participation in athletics is an honor and a privilege earned through dedication, desire, and discipline. At Metrolina, we believe the athlete must discipline himself not only physically but academically, spiritually, and socially in order to achieve excellence. The purpose of athletics at MCA extends to the following: Providing instruction and direction to use our athletic talents to glorify God. (1 Peter 4: 11) Applying the principle of the well-rounded person illustrated in Luke 2:52 (mental, physical, social, and spiritual) through the integration of academics, athletics, and social activities. Promoting the biblical definition of winning. o Doing our best for God s glory. (Col. 3:23) o Physically winning the game. (I Cor. 9:24) o Acknowledging God in all things, win or lose. (I Thess. 5:18) o Seeking God s guidance in striving to be a true winner. (Phil. 4:13) Developing school unity and spirit through involvement by the student body, parents, faculty, and staff. (1 Corinthians 12) Maintaining a clear Christian testimony to opposing schools, officials, and others in the public with whom we interact. (Matthew 5:16) Attendance Team members of each sport should attend all scheduled practices and meetings. If circumstances arise whereby the student cannot attend a practice or meeting, the coach should be notified prior to by personal contact, phone call, or written statement from the parent or guardian. Any athlete, who misses practice, fails to appear for a game, fails to make scheduled individual or team meetings, or fails to attend school more than one-half day on game days or practice days may not be allowed to suit up for any game or games for a period of time to be determined by the coach and Athletic Director. Excessive absence may be cause for removal from athletics. Eligibility Students wishing to participate in athletics should maintain an academic standard of excellence. Those who fall below that standard will be required to divert time from athletics to academics. Students must maintain an overall C (2.0) grade average with no failing grades in any class. Students may become ineligible based upon their grades at the 4 ½ week progress report and the 9 week report card grade. If a student becomes ineligible at the 4 ½ week progress report, he/she may be reinstated to the team after a 5 school day period if all grades meet the eligibility standard. If a student becomes ineligible at the end of 9 weeks, he/she may be reinstated to the team again after a 15 school day period if all grades meet the eligibility standard. While ineligible, an athlete may not attend practice or games. Personal Appearance Because an athlete is constantly in the eyes of the public, he becomes a representative of the school and is considered to be in a position of leadership. Therefore, the athlete s personal appearance not only reflects his/her attitude but those whom he/she represents. Athletes are required to follow Metrolina s dress code and any other standards imposed by the coach. Failure to comply may result in suspension from the team and/or removal from athletics. Fees Each student will be assessed an annual athletic fee of $150. Football fees are $300 for Junior Varsity and Varsity. Cheerleading fees vary depending on uniform, apparel, etc. This fee covers athletes for the entire school year. Student athletic fees are due before the first game and should be given to the proper coach or paid in the school office. For bookkeeping purposes, parents will have their accounts billed. 1

2 PARENT/STUDENT ATHLETE COOPERATION FORM GUIDELINES FOR AWAY TRIPS Assignments/Tests Athletes are to make sure that any tests be taken or assignments turned in prior to leaving for an away game. Athletes returning late from a game will not be excused from any tardiness or from assignments or tests given the following day unless it is approved by the athletic director and principal. Dress School dress uniform or team athletic uniform, as determined by the coach, will be required for away games. Travel We believe that having the team ride together to away games helps build team spirit. Therefore, all students should ride together to and from away games unless prior arrangements have been made with the coach. Students riding home from an away game with anyone other than their parents/guardians must have parental permission and inform the coach. There is to be no screaming or yelling on the bus. Keep hands and feet inside the windows at all times. Standing and moving around on the bus should be avoided. Male and female athletes are not permitted to sit together on the bus while traveling to or from an away game. Vehicles The bus should be cleaned after every trip. This is the responsibility of every athlete who rides on the bus. Any damage done to vehicles from horseplay or carelessness will be the responsibility of the individual(s) who caused the damage. Technical Fouls/Cautions/Ejections Any athlete receiving a conduct technical foul in basketball, a caution (yellow card) in soccer, a caution (yellow card) in volleyball, or a verbal caution in baseball will be removed from that game/match and will remain out of that game for any time deemed necessary by the head coach. Any athlete receiving a caution or technical in two consecutive games will be removed from the remainder of that game and suspended from the following game. Any athlete receiving two technical fouls in one game or an ejection suspended from the following game. Any athlete who is suspended from two games for cautions or ejections may be removed from the team for the remainder of the season. NCAA Eligibility Center: If your child has a desire to play college sports they need to be registered with the eligibility center at the beginning of their junior year. You can complete the registration online at The cost is around $85.00 and this MUST be done for a college bound student-athletes to be eligible to participate in NCAA division 1 or 2 collegiate athletics their freshmen year in college. There is a guide that you need to read which is available online. SAT/ ACT: Make plans for your child to take either or both the SAT/ ACT (several times) and be sure they enter the NCAA eligibility center code "9999" as a score recipient. Doing this sends the score directly to the NCAA eligibility center. Effective Parent/Coach/Player Relations at MCA 2

3 PARENT/STUDENT ATHLETE COOPERATION FORM Effective relationships between parents, coaches, and players must be built on the following guidelines: Love one another. A new command I give you: love one another. As I have loved you, so you must love one another. By this all men will know that you are my disciples, if you love one another. (John 13:24-35) Respect each other. Be devoted to one another in brotherly love. Honor one another above yourselves. (Romans 12:10) Pray for each other. On Him we have set our hope that he will continue to deliver us, as you help us by your prayers. Than many will give thanks on our behalf for the gracious favor granted in answer to the prayers of many. (II Cor. 1:10b-11) With full recognition of, and respect for parental responsibility under God, it must be kept in mind that for athletic participation, parents have delegated the responsibility and authority for the young person to the coach. Hands-on delegation is not acceptable. The following examples must be avoided: Parental coaching from the stands. A coach needs the full attention and concentration of his players. During a practice or game, the player belongs to the coach. Uninvited parental intervention during these times is a serious distraction and is detrimental to the program. Parents negatively approaching the coach or their young person on the bench during a game, at halftime, or immediately after a game prior to the post-game team meeting. A coach expects the full support from both the player and parents(s). If a parent wants to talk to the coach, he/she should call the next day. Parents wishing to give input should use the proper communication channels and procedures. If their concern/input is not heard or sufficiently responded to by the coach initially, they may proceed by talking with the athletic director, principal, and then to the Head of School until the matter has been closed. Proper deference should be given to the coach by scheduling an appointment with him/her to discuss concerns in private. It is reasonable to expect that any parent, who has permitted his/her young person to try out for a team, be supportive of the coach. Any concerns should be given privately to a coach if need be; however simply airing negative opinions to others, including one s own children, should be avoided. Each coach will have the full responsibility and authority to determine which players are entered into games, when, and for how long. His/her determination in this area will be made on the basis of what will best benefit the team. In team sports, the team will always be of primary significance. The coach will choose a starting lineup for each game based on ability, attitude, and performance in practices and games. Substitutions will be made when an injury occurs, when a player is tired or not playing well, or when the outcome of the game is out of questions. Substitutions are made at the discretion of the coach. Parent Train up a child in the way he should go and when he is old he will not part from it. Proverbs 22:6. You as a parent must play an active role during these short years to ensure athletic and academic success. Coaches have been prayerfully chosen and I urge you to support them as they sacrifice their time for the benefit of your child. Rest, prayer, and a proper diet are essential for your child s success at Metrolina. Please feel free to contact me or other coaches as we encounter yet another year. Your prayers and support are vital to our athletic program. *Metrolina reserves the right to review all cases at their discretion **All parents should refer to the Athletic Handbook online as it addresses various aspects of our program from philosophy and dress codes to fees and eligibility.. Metrolina Christian Academy believes the above policies must be agreed on and understood between the school, the student athlete, and the parents. By signing below, I am indicating my acceptance of the above stated policies. 3

4 PARENT/STUDENT ATHLETE COOPERATION FORM PARENT PLEDGE 1. I pledge to use positive encouragement to edify my child because I understand that athletes do their best when encouraged. 2. I understand that fewer than 1% of youth sports participants receive athletic scholarships and the top three reasons kids play sports are: a) to have fun; b) to make new friends; and c) to learn new skills. 3. I understand that the game is for the players, and I will keep sports in the proper perspective. 4. I pledge to encourage my child to use maximum effort, to learn new skills, and to bounce back from mistakes. 5. I understand that children have different natural abilities and are at different levels of physical development and that the true measure of my child s success is not how my child compares to others, but how he/she is doing in comparison to his/her best self. 6. I pledge to Honor the Game. I understand the importance of setting a good example for my child and that my child might be embarrassed by any out-of-bounds behavior on my part. No matter what others may do, I will show respect for all involved in the game including coaches, athletes, opponents, opposing fans, and officials. I understand that officials make mistakes. If the official makes a bad call against my team, I will Honor the Game and be silent. 7. I pledge to refrain from calling out instructions to my child or approaching the bench during a game or breaks in a game. I understand that this is the coach s job. I will limit my comments during the game to encouraging my child and other players for both teams. 8. I pledge to refrain from making negative comments about my child s coach in front of my child, my child s teammates, or other team parents. If I have a conflict with a coach, I pledge to handle it in a Biblical manner and approach the coach directly, privately, and respectively. 9. I will be on time to pick up my child from all games and practices. This shows respect for the coach, and it tells my child that he/she is my top priority. 10. I have read and fully understand that if I have not kept my agreement to fulfill the above stated obligations; my child will be removed from Metrolina Athletics. Parent Electronic Signature on attached link 4

5 PARENT/STUDENT ATHLETE COOPERATION FORM Student An athlete is expected to govern his or her conduct in accordance with the rules and regulations of the Student Handbook. Violation of the student s obligations under the handbook may result in removal from competitive athletics.. STUDENT PLEDGE 1. I pledge, in my words and actions, to encourage my teammates and coaches. 2. I will make my MCA team one of my top priorities and will not miss practices or games because of extracurricular activities. 3. I will use maximum effort, learn new skills, and bounce back from mistakes. I will work every day to my best ability in order to grow as an athlete and a person and to help my team improve. 4. I will show respect to opposing athletes, opposing fans, opposing coaches, and officials. I will refrain from trash talking or questioning calls by officials. I will not engage in any kind of conversation with an opposing coach. After the game, I will conduct myself with dignity win or lose- by offering a handshake to opposing players. 5. I pledge to listen to and to follow my coach s instructions. I understand that for any relationship to work there has to be a mutual trust. I will trust my coach s plan for my team, and I will earn his/her trust by following through with what he/she would have me do. 6. I pledge to refrain from making negative comments about my coach to teammates and other students. I understand this can seriously damage team morale and chemistry and undermine my coach s ability to do his/her best. If I have a conflict with a coach, I pledge to handle it in a Biblical manner and approach the coach directly, privately, and respectively. 7. I will be on time to practices and games. I understand that being late might put me at risk by not providing adequate time for warm-up. 8. I have read and fully understand that if I have not kept my agreement to fulfill the above stated obligations, I will be removed from Metrolina Athletics. Student Electronic Signature on attached link 5

6 MEDICAL RELEASE & INSURANCE COVERAGE Referral to a Medical Specialist If the Athletic Trainer is of the opinion that a particular injury requires referral to a medical specialist for further evaluation or treatment, he/she will contact the parents of the injured athlete in order to make arrangements for that athlete to be seen by the proper medical professional. Coaches do not have the authority to make referrals to any physician without the approval of the Athletic Trainer, except in cases where emergency care is indicated. Before the athlete can return to athletic participation, the Athletic Trainer must receive and review all medical records pertaining to the injury. It is the responsibility of the athlete and his/her parents to insure that the physician forwards all requested information. Return to Activity Following an Injury Athletes who have missed practices or games due to a particular injury or illness must be re-evaluated by the Athletic Trainer before they are allowed to return to active participation. Any athlete who has been under the care of a physician for a particular injury or illness must turn in a completed Athletic Medical Clearance Form to the Athletic Trainer. Written clearance to participate does not guarantee that the athlete will be able to immediately return to the highest level of activity in their particular sport. Therefore, it is important for the Athletic Trainer to re-evaluate an athlete in order to determine the athlete s readiness to return to activity and at what level of activity it is safe for the athlete to return to participation. Coaches must communicate with the Athletic Trainer BEFORE allowing an athlete to return to activity following an injury. Please follow the Athletic Trainer s recommendations. Any athlete who fails to report an injury or who fails to report being treated by a physician for a particular injury assumes all risk for continued participation in practice or contests. Consent for Emergency Care and Financial Responsibility I, the undersigned parent/guardian of the student applicant for interscholastic participation, do give and grant to any medical doctor or hospital my consent and authorization to render such aid, treatment, or care to said student as, in the judgment of said doctor or hospital, may be required in an emergency, illness or accident. This permission is granted while the student is participating in or traveling to or from an ATHLETIC EVENT conducted by Metrolina Christian Academy. This permission is granted for the current school year. We as parent(s) or legal guardian(s) assume full financial responsibility for such action. Metrolina Christian Academy, its employees, and parent volunteers will not be held liable for personal injury occurring as the result of participation in ATHLETIC activities. INSURANCE Athletic Insurance 1

7 MEDICAL RELEASE & INSURANCE COVERAGE Because the risk of injury increases for students involved in athletics, all student athletes participating on MCA athletic teams must be covered by health insurance. It is the responsibility of the athlete s parents to provide insurance in the event of an injury while participating in practice or in a game. Metrolina Christian Academy does not assume any financial responsibility for injuries while participating on an athletic team. Risk We the parents acknowledge and understand that there is a risk of injury involved in athletic participation. We understand that the student-athlete will be under the supervision and the instructions of the coach in order to reduce the risk of injury to the student and the other athletes. However, we acknowledge and understand that neither the coach nor Metrolina Christian Academy can eliminate the risk of injury in sports. Injuries may and do occur. Sports injuries can be severe and in some cases may result in permanent disability or even death. We freely, knowingly and willfully accept and assume the risk of injury that might occur from participation in athletics. Responsibility In the event we the parents cannot provide insurance at the time of injury we understand we are fully responsible for any cost related to the injury. Metrolina Christian Academy does not offer student insurance. Metrolina Christian Academy has an excess insurance policy, which means after the insured person has been reimbursed for the medical expenses by other insurance plans, this excess insurance will pay up to the maximum medical expense benefit of the policy for any remaining treatment, services or charges. Insurance Coverage I have read and understand that as a parent/legal guardian, I accept full financial responsibility regarding medical treatments in accordance with the INSURANCE section of this document. Please submit the following information on the attached link. Insurance Company Employer Name of Insured Parent Policy # Policy Holder s Electronic Signature on attached link Transportation Permission Applicant has permission to ride in transportation provided by Metrolina Christian Academy (bus, van, or parent vehicle, if necessary.) Parent Initials on the attached link 2

8 NOVANT HEALTH PRESBYTERIAN SPORTS MEDICINE PERMISSION TO TREAT FORM Concussions What is a concussion? A concussion is an injury to the brain caused by a direct or indirect blow to the head. It results in your brain not working as it should. It may or may not cause you to black out or pass out. It can happen to you from a fall, a hit to the head, or a hit to the body that causes your head and your brain to move quickly back and forth. How do I know if I have a concussion? There are many signs and symptoms that you may have following a concussion. A concussion can affect your thinking, the way your body feels, your mood, or your sleep. Here is what to look for: Thinking/ Remembering Difficulty thinking clearly Taking longer to figure things out Difficulty concentrating Difficulty remembering new information Physic a l Emotional /Mood Sleep Headache Irritability-things bother Sleeping more you more easily than usual Fuzzy or blurry vision Sadness Sleeping less than usual Feeling sick to your Being more moody Trouble falling stomach/queasy asleep Vomiting/throwing up Feeling nervous or worried Feeling tired Dizziness Balance problems Sensitivity to noise or light Crying more Table is adapted from the Centers for Disease Control and Prevention ( What should I do if I think I have a concussion? If you are having any of the signs or symptoms listed above, you should tell your parents, coach, athletic trainer or school nurse so they can get you the help you need. If a parent notices these symptoms, they should inform the school nurse or athletic trainer. When should I be particularly concerned? If you have a headache that gets worse over time, you are unable to control your body, you throw up repeatedly or feel more and more sick to your stomach, or your words are coming out funny/slurred, you should let an adult like your parent or coach or teacher know right away, so they can get you the help you need before things get any worse. What are some of the problems that may affect me after a concussion? You may have trouble in some of your classes at school or even with activities at home. If you continue to play or return to play too early with a concussion, you may have long term trouble remembering things or paying attention, headaches may last a long time, or personality changes can occur once you have a concussion, you are more likely to have another concussion. How do I know when it s ok to return to physical activity and my sport after a concussion? After telling your coach, your parents, and any medical personnel around that you think you have a concussion, you will probably be seen by a doctor trained in helping people with concussions. Your school and your parents can help you decide who is best to treat you and help to make the decision on when you should return to activity/play or practice. Your school will have a policy in place for how to treat concussions. You should not return to play or practice on the same day as your suspected concussion. You should not have any symptoms at rest or during/after activity when you return to play, as this is a sign your brain has not recovered from the injury. This information is provided to you by the UNC Matthew Gfeller Sport-Related TBI Research Center, North Carolina Medical Society, North Carolina Athletic Trainers Association, Brain Injury Association of North Carolina, North Carolina Neuropsychological Society, and North Carolina High School Athletic Association. 1

9 NOVANT HEALTH PRESBYTERIAN SPORTS MEDICINE PERMISSION TO TREAT FORM Student Athlete & Parent Concussion Statement *If there is anything on this sheet that you do not understand, please ask an adult to explain or read it to you. Student-Athlete Name: This form must be completed for each student-athlete, even if there are multiple student-athletes in each household. Parent/Legal Custodian Name(s): We have read the Student-Athlete & Parent/Legal Custodian Concussion Information Sheet. If true, please check box. Student- Athlete Initials A concussion is a brain injury, which should be reported to my parents, my coach(es), or a medical professional if one is available. A concussion can affect the ability to perform everyday activities such as the ability to think, balance, and classroom performance. A concussion cannot be seen. Some symptoms might be present right away. Other symptoms can show up hours or days after an injury. I will tell my parents, my coach, and/or a medical professional about my injuries and illnesses. If I think a teammate has a concussion, I should tell my coach(es), parents, or medical professional about the concussion. I will not return to play in a game or practice if a hit to my head or body causes any concussion-related symptoms. I will/my child will need written permission from a medical professional trained in concussion management to return to play or practice after a Based on the latest data, most concussion. concussions take days or weeks to get better. A concussion may not go away right away. I realize that resolution from this injury is a process and may require more than one medical I realize that ER/Urgent Care physicians evaluation. will not provide clearance if seen right away after the injury. After a concussion, the brain needs time to heal. I understand that I am/my child is much more likely to have another concussion or more serious brain injury if return to play or practice occurs before concussion symptoms go Sometimes, repeat concussions away. can cause serious and long-lasting I have read the concussion symptoms problems. on the Concussion Information Sheet. Parent / Legal Custodian Initials N/A N/A N/A After reading the information sheet, I am aware of the following information: Student-Athlete Electronic Signature on attached link Parent/Legal Custodian Electronic Signature on attached link 2

10 NOVANT HEALTH PRESBYTERIAN SPORTS MEDICINE PERMISSION TO TREAT FORM Release: In consideration of the student-athlete named above, I/we agree to release and hold Novant Health Presbyterian Sports Medicine, its Certified/Licensed athletic trainers (ATC) and/or other related licensed health care providers free, harmless and indemnified from and against any and all claims, suits, or causes of action arising from providing medical care to this student-athlete. Parental Permission: I hereby give my consent and grant permission for medical treatment deemed necessary for any conditions arising while participating in interscholastic athletics, provided by Novant Health Presbyterian Sports Medicine ATC s. This would include use of any medication(s) such as Albuterol or and Epipen to treat allergic reactions (e.g., bee sting) or restrictive airways reactions (e.g., exercised-induced asthma) should such emergent need arise. If my child s injury/illness requires care not available on site, I understand every effort will be made to contact me prior to treatment being rendered at an off campus facility. I also grant permission for the ATC to release pertinent information to related health care providers, as well as those providers to release pertinent information to the ATC regarding care of the above named student-athlete. In addition, I agree to permit the ATC to release all pertinent information regarding the above named student-athlete s school personnel. These would include, but are not limited to the coaches, athletic director, administration, guidance counselors, and teachers on a need-to-know basis to best serve the needs of the student-athlete. Parent/Legal Custodian Electronic Signature on attached link Electronic Signature Page 3

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