*
*
PERMISSION TO PLAY If an athlete, I also take responsibility for the risk involved in playing interscholastic sports and understand that there is a possibility of injury. Civic Memorial High School will continue to make every sport as safe as possible. I understand the rules and regulations of the Civic Memorial High School Athletic/Activity Handbook and support my son/daughter and the coaching staff in enforcing these rules and regulations. I, as a parent or guardian, also understand that there is a risk involved in playing interscholastic sports and realize that there is a possibility of injury to my son or daughter.
*
IHSA SPORTS MEDICINE ACKNOWLEDGEMENT & PHYSICAL FORM By signing this form, we acknowledge we have been provided information regarding concussions and the IHSA Performance-Enhancing Substance Policy. All of these items can be found on the school website. I understand that every athlete must have a current physical on file with the school. I understand without a current physical the athlete will be unable to participate, including tryouts, until a current physical is on file at Civic Memorial High School.
*
ATHLETIC ACTIVITY HANDBOOK PLEDGE SHEET I have received the Civic Memorial Athletic/Activity Handbook and agree to adhere to all the rules and regulations enclosed. I understand that failure to abide by these rules/regulations and any other reasonable rules established by the coach/advisor may result in my removal from the team/squad/organization.
*
*
WAIVER OF INSURANCE We, the undersigned, being the natural parents, guardians of or persons standing in loco parentis of the student named below presently enrolled in Bethalto Community Unit School District #8, of Madison County, Illinois, hereby agree to carry health insurance on said student for the purpose of paying health care costs of any injuries or disabilities received as a result of said student participating in cheerleading, drill team, color guard, athletics or other extra-curricular activities while a student in said district. Said activities including but not limited to, basketball, track, baseball, tennis, football wrestling, volleyball, softball, golf, soccer, cross country and weight lifting. The undersigned acknowledges the opportunity to purchase student accident insurance coverage but specifically decline the same and agree to hold said District harmless and indemnify it from any expenses or damages incurred as a result of said student participating in the aforementioned athletics, or other extra-curricular activities. The undersigned hereby acknowledge that the District is not carrying any type of health insurance on said student. The undersigned further agree that in the event our private insurance is canceled or, for any reason terminated, we will immediately notify the School District and make arrangements to obtain student accident insurance, which is available from a designated insurance company. It is understood and agreed that no student will participate in athletics or other extra-curricular activities sponsored by Bethalto Community Unit School District No. 8, unless said student is covered by health insurance.
*
*
*
*
*
*
*
AGREEMENT By typing my full name below I understand the following: I have read, agree to abide by and understand the provisions that are in the CMHS Athletic Code of Conduct and the provisions stated in the IHSA concussion form. Both can be found on the CMHS Athletics website under the Athletic Paperwork tab. I have read and understood all the information above and that if I have any questions I can contact the school.
*
*