ST. BENEDICT PREPARATORY SCHOOL ATHLETE CONTRACT PERMISSION TO PARTICIPATE IN ATHLETICS

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1 ST. BENEDICT PREPARATORY SCHOOL ATHLETE CONTRACT PERMISSION TO PARTICIPATE IN ATHLETICS I HEREBY GIVE PERMISSION TO (STUDENT S NAME) TO PARTICIPATE IN SPORTS AT ST. BENEDICT PREPARATORY SCHOOL, AND, AS A PARTICIPANT, TO TRAVEL UNDER THE COACH S DIRECTION AND AUTHORITY FROM THE TIME OF DEPARTURE UNTIL THE RETURN ARRIVAL. NAME OF FATHER S WORK: WORK ADDRESS: WORK PHONE NUMBER: NAME OF MOTHER S WORK: WORK ADDRESS: WORK PHONE NUMBER: HOME ADDRESS: HOME PHONE NUMBER: CELL PHONE NUMBER(S): ADDRESS(ES): INSURANCE COMPANY NAME: POLICY # NAME OF POLICY HOLDER: SPECIAL MEDICAL INSTRUCTIONS: SIGNATURE OF PARENT / GUARDIAN DATE

2 St. Benedict Preparatory School Uniform Contract This contract is drawn under the supervision of the St. Benedict Preparatory School s Administration and must be completed by any students and their parent/guardian who agrees to use uniforms or equipment belonging to the school. Sport: Season and School Year: THIS SECTION IS TO BE FILLED BY ADMINISTRATION OR COACH The last day the uniform/equipment can be returned without being charged the replacement cost: Uniform Issued: Size: Number: Replacement Cost: Jersey: Shorts/Pants: Warm-Ups: Additional equipment issued that must be returned (with the replacement cost): The undersigned student and parent/guardian agree to return the above designated uniform and equipment by the date noted above in the Last Day clause. People that do not return the uniform/equipment by the above listed day, or do not return the uniform/equipment in what the Administration of St. Benedict Preparatory School considers to be satisfactory condition, will be billed the entire replacement cost ($75 per article) onto their tuition statement. By signing this form, the parent/guardian agrees to the above stated agreement. This contract is made and subscribed to by the coaches and the Athletic Department of St. Benedict Preparatory School for the student and parent/guardian named below: Student s Name (Please Print) Parent/Guardian's Signature Supervising Coach s Name

3 AN ATHLETE S OATH My parents and I acknowledge that participating in sports at St. Benedict Preparatory School is a privilege and an educational experience. Students who participate in sports set examples for the other students; thus voluntarily participating in sports automatically requires the student to accept certain responsibilities. Among these responsibilities are: I will never use abusive language, I will not engage in abusive behavior, I will not use drugs, alcohol, or tobacco, I will always set a good example of sportsmanship. Not only will I not engage in these activities, but also I will set an example for other students to follow. Setting a good example means that I will not participate or encourage others to participate in negative behaviors or activities. I will do my best in the classroom and on the athletic field, always working to improve myself as a person, student and an athlete. Athletes agree to respect the rules and policies of the athletic department, respect their coaches and other school officials. Parents understand and agree that your child's participation in sports also holds responsibilities for parents. Parents' basic responsibilities include supporting your child, respecting the rules and policies of the athletic department, respecting coaches and other school officials, and respecting the players, fans, coaches, and school officials of the other schools we play. A parent also agrees to be a role model for the athletes and for other parents. Being a role model means not supporting drug and alcohol use among young people by not drinking on or near school property, not allowing alcohol or drug use by minors in your home, and not promoting alcohol or drug use by your attitudes and language around young people. Both the athlete and parents agree and pledge that the violation of this personal, solemn oath indicates that the athlete is not able to participate in the sports program at this time until further growth and maturity occur that will allow the athlete and parents to again participate. Parent s Name: Parent s Signature: Athlete s Name: Athlete s Signature:

4 Archdiocese of Chicago Child/Minor Athletic Participation Release Form Child/Minor Name: Address: Parent/Guardian Name: Home Telephone: Work Telephone: Important information The Catholic Bishop of Chicago (the CBC) and ST. BENEDICT PREPARATORY SCHOOL (the Parish) are committed to conducting its athletic programs and activities in the safest manner possible and holds the safety of participants in the highest possible regard. Participants and parents registering their child in athletic programs must recognize however, that there is inherent risk of injury when choosing to participate in athletic activities. The CBC and the Parish continually strive to reduce such risks and insist that all participants follow safety rules and instructions which have been designed to protect the participant s safety. Please recognize that the CBC and the Parish do not carry medical accident insurance for injuries sustained in its programs. The cost of such would make program fees prohibitive. Therefore, each person registering themselves or a family member for a recreation program/activity should review their own health insurance policy for coverage. It must be noted that the absence of health insurance coverage does not make the CBC or the Parish automatically responsible for the payment of medical expenses. Due to the difficulty and high cost of obtaining liability insurance, the agency providing liability insurance coverage for the CBC and the Parish requires the execution of the following Waiver and Release. Your cooperation is greatly appreciated. Waiver and Release of All Claims Please read this form carefully and be aware in registering your minor child/ward for participation in this program you will be waiving and releasing all claim for injuries you or your minor child/ward might sustain arising out of this program. Program: Program s: As the parent/guardian of the participant in the program, I recognize and acknowledge that there are certain risks of physical injury and I agree to assume the full risk of any injuries, (including death), damages, or loss which I or my minor child/ward may sustain as a result of participating in any and all activities connected with or associated with such program. I agree to waive and relinquish all claims I or my minor child/ward may have, as a result of participating in the program, against the CBC, the Parish and their agents, servants and employees. I do hereby fully release and discharge the CBC and the parish and their officers, agents, servants, and employees from any and all claims from injuries, (including death) damage or loss which I or my child/ward may have or which may accrue to me or my minor child/ward on a account of participation in the program. I further agree to indemnify and hold harmless and defend the CBC, the parish and their officers, agents, servants and employees from any and all claims resulting from injuries, (including death), damages and losses sustained by me or my minor child/ward or arising out of, connected with, or in any way associated with the activities of the program. In the event of any emergency, I authorize the CBC or parish officials to secure from any licensed hospital, physician, and/or medical personnel any treatment deemed necessary for my minor child s immediate care and agree that I will be responsible for payment of any and all medical services rendered. I have read and fully understand the above Program Details, Waiver and Release of All Claims and Permission to Secure Treatment. Parent / Guardian Signature

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