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Extracurricular Athletics Consent

Extracurricular Athletics Consent
This Consent Form must be signed annually by parents/guardians in order for their children to participate.

Dear Parent: Here is some basic information you need to be aware of in order for your child to participate in extracurricular athletics. Please consult your Parent/Student Handbook or the Athletic Director for more information. After reading this carefully, please sign the consent at the bottom of this page. Thanks for your support.

SPORTS ACCIDENT INSURANCE
Temple Academy carries insurance to cover student athletes that are injured during a game or practice and are not covered under another plan. The school’s insurance is secondary to parent or guardian health plans.

EMERGENCY CARE
In case of emergency illness or accident the child is given first-aid and the parents are notified. If the parents or the child’s doctor cannot be located, the child will be taken to the Emergency Room of their choice, if available. Temple Academy does not assume responsibility for the payment for the hospital, doctor, or ambulance fees. Sports Participation Emergency Medical Cards will be on file with the coaches.

DROP-OFF AND PICK-UP OF PLAYERS
Students should not be dropped off more than 15 minutes prior to the activity and must be picked up within 15 minutes after the activity. Please remember our coaches are volunteers and prompt pick up is appreciated.

RESPONSIBILITY FOR DAMAGES
Athletes will be liable for any lost or damaged school-issued supplies and for damages to any school facilities, whether Temple Academy’s or other schools.

SPORTS FEE***
Sports fees will be announced. Fees will be charged for each child per sport to help defray the costs of the program. They are due before uniforms are issued or arrangements must be made with the bookkeeper. Parents are required to perform four (4) hours of volunteer time or be charged $10 an hour for hours not served for soccer, baseball and softball. Parents are required to perform eight (8) hours of volunteer time or be charged $10 an hour for hours not served for basketball.

WARNING OF INHERENT RISK THROUGH PARTICIPATION IN ATHLETICS
Participation in athletics, especially contact and collision type sports can result in bodily injury to the athlete. The Temple Academy Coaching Staff will take every reasonable precaution to ensure that athletes are protected from injury.

Student Name: *

(First Name Last Name)

Grade: *

Date of last complete physical: *

Performed by: *

PARENT CONSENT: *

I give my permission for the child listed above to participate in Temple Academy extracurricular athletics and to travel with their team by bus, van or parent automobile. I understand and will support the school’s policies governing the extracurricular program. I understand the inherent risk of participation in athletic activities and agree to hold harmless and without fault Temple Academy, all staff hereof and any other school representative for any injury to my son/daughter which may arise out of the course of said activities.

Father/Legal Guardian Signature: *

(First Name Last Name)

Mother/Legal Guardian Signature: *

(First Name Last Name)

**In accordance with the above policy, I have either turned in a current sports exam form signed by a physician, or completed the Medical Questionnaire.