mrolf(cl)bolingisd.net

Attention interested IJH Cheer Candidates

Cheer Tryouts

2020-2021

The following is a list of details for the upcoming cheer tryouts for Iago Junior High School2020-2021 Cheer Squad. We will be having our tryouts using an online process this year due tothe current Covid-19 restrictions.

Sign-up by em ailing Ms. Rolf our IJH Cheerleading Sponsor:

Be sure to include in the email:

The CheerleaderlParent Acknowledgement Signed

Sudden Cardiac Arrest Form Signed

Concussion Acknowledgement Form Signed

UIL Parent and Student Agreement Form Signed

List three Core Subject Teachers (Math, Reading, Science, Social Studies) to completeyour Teacher Recommendations (we will give the forms to the teachers to be completed)

Also include parent/guardian contact numbers along with email addresses.

Timeline for Cheerleading tryoutsSign-up April 13-17,2020 (Sign-ups due by 5:00pm April 17)

Cheer Routine video emailed out for home practice April 20, 2020

Practice Cheer Routine at home April 20-23, 2020

Submit video of your Cheer Tryout April 24, 2020 mroWcZbolingisd.net

(Tryout Video due by 5:00pm April 24)

2020-2021 Cheerleaders to be posted on Monday April 27, 2020

If you have any questions, please call Iago Junior High 979-657-2826. Printed packets may bepicked up Monday through Thursday April 13-16,2020 8am-11am.

2020-2021Iago Junior High Cheerleading Handbook

Sponsor: Maegan Rolf

It shall be the purpose of the Cheerleading Squad to promote anduphold team spirit for those we encounter, to develop good

sportsmanship, to support good relations in the community and betweenteams during all events. The organizational goal is to work in harmony

with each other, athletic teams, and the school administration.

Contents of Handbook

Contact Information

1. Organization2. Requirements for Tryout Eligibility3. Election and Tryouts4. Mandatory Responsibilities (Required Events)5. Duties of the Head Cheerleader6. Duties of the Cheerleader7. Citizenship8. Uniforms9. Conduct during events10. Games and Pep Assemblies11. Discipline Procedures

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1. ORGANIZATION

A. Squad: There will be 8 cheerleaders. The squad will consist of eight students fromgrades 6, 7, and 8. There will be 2 members from the 6th grade, 3 members fromthe Jth grade, and 3 members from the 8thgrade.

B. These students will retain their positions for the entire year unless dismissed fromtheir positions for morality or not fulfilling responsibilities set up in this policy.

2. REQUIREMENTS FOR TRYOUT ELIGmILITY

A. Must have been or is a member of: cheerleaders, band, pep squad, or athleticorganization prior to the spring cheerleader tryouts.

B. Transfer Students - Must have been a cheerleader, mascot, member of drill teamor pep squad, band or athletic organization for the school year of the springtryouts.

C. Cheerleader candidates must have an average of 80 or above in each academiccourse for the combined grading periods (1st through 4th six-weeks) of the currentschool year prior to tryouts. Academic courses are all courses except P .E.,Athletics, Homemaking, Band, or Art.

D. All candidates must have parents read and sign the information sheet and return apermission slip BEFORE they tryout.

E. Must not have a "U" in citizenship in any grading period prior to tryouts.F. Citizenship

1. ISS - Must not have been assigned 3 or more days for the current schoolyear prior to tryouts.

2. Discipline Referrals - Must not have been referred to the office 5 or moretimes for current school year prior to tryouts.

3. Must not have been dismissed nor dismissed themselves from anyorganization such as cheerleading, drill team, pep squad, band, or anyathletic school related group(s) in the past two school years for anydiscipline reasons or irreconcilable differences.

G. All candidates must have a current physical from a licensed physician on recordbefore tryouts. A current physical for the 2020-2021 school year is required if thecandidate is elected a cheerleader.

3. ELECTION AND TRYOUTS

A. Cheerleader tryouts are conducted in the spring of the year.B. A three day workshop, taught by the 8thgrade cheerleaders and conducted by

the sponsor, will precede the tryouts.C. The workshop is for all eligible candidates from 5th to 7th grades. It is

MANDATORY that all eligible candidates attend the workshop.D. Character screening (teacher evaluation). Cheerleader candidates will submit

to the sponsor the names of three of their teachers they wish to evaluate them.They will be graded on dependability, cooperation and attitude, leadershipabilities, and effort. The cheerleader sponsor has the responsibility to securethe required evaluations.

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E. Three out of town judges will rate the candidates on overall appearance,technique, spirit projections, and voice.

F. Candidates for head cheerleader will also submit an essay of why they shouldbe head cheerleader and how they can lead the squad to be reviewed by acommittee. Up to 5 points can be added for the essay.

G. Selection will be by a combined scoring process:1. Teacher Evaluation points will be multiplied by 2; and2. Rating of Judges Points will be multiplied by 3.This will determine the point total of each candidate. The candidates will beranked by total points.Selection of Head Cheerleader3. Must be an 8th grader.4. Must have had one year experience as a cheerleader.5. Ifthe above requirements are met, the 8th grade candidate receiving the

most points will be head cheerleader.6. Ifno 8th grade candidates meet the above requirements, the 7th grade

candidate with experience as a cheerleader will be considered. If morethan one candidate is eligible, those receiving the most points will behead cheerleader.

7. In the event that no candidate has cheerleader experience, the candidatein the highest grade classification with the most points will be headcheerleader.

4. MANDATORY RESPONSIBILITIES (REQUIRED EVENTS)

• 2 Fundraisers - Fundraiser for uniforms(optional) and a general fundraiser(not optional)

• 1week of Summer Camp ( instruction and sign painting)• Picture Day (Group Picture)• Participate and Prepare Pep Rallies• Pep Rally at Newgulf Elementary• All Practices ( Wednesdays after school till 5 )• All Football Games (home and away)

* * * Packing and unpacking of the vehicle for home and away games is a chore thathas to be done and the responsibilities will be spilt up among the squad. DEMERITSWILL BE GIVEN if this duty becomes a problem.

5. DUTIES OF THE HEAD CHEERLEADER

A. Together with the sponsor, coordinate and designate the practice days andtimes for both summer and the school year.

B. Together with the sponsor, designate uniforms to be worn for all games, pepassemblies, summer camps, and any other cheerleader functions

C. To work with the sponsor and help keep the squad working together.D. To make the sponsor aware of any problem among the squadmembers.E. To keep the sponsor informed of the requested cheerleader activities.F. To designate cheers and chants at games and pep assemblies.

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G. To conduct a cheerleader workshop in the spring under the sponsor'ssupervision.

6. DUTIES OF THE CHEERLEADERS

A. Work with the sponsor to increase school spirit.B. Plan and conduct the best possible Pep RalliesC. Lead yells at all Football games.D. All cheerleaders must attend the summer cheerleading camps as a squad.E. Activities outside of school should not interfere with the games and pep

rally assemblies or practices that the cheerleaders must attend during theschool year.

F. Mandatory summer practice will be set by the sponsor.

7. CITIZENSIllP

A. ISS/Suspension - Assignment of ISS or Suspensionwill result in thefollowing:1. 1 full day - warning (or probation).2. 2 full days - suspension (removal for remainder of the year).

Note: if the suspension falls on the current semester tryouts are held, studentmay not tryout.

B. Discipline Referrals - Five (5) referrals will result in suspension for thecurrent semester.

C. Cheerleaders may not smoke, drink alcoholic beverages, use profanity or useillegal drugs while in or out of uniform.

*** Violation will result in removal from squad. ***8. UNIFORMS

A. All uniforms will be bought by the parents ($700-$900) and approved by thesponsor and the administration. There will also be a camp fee of$160.Parents will be responsible to pay for camp ($160)when we orderuniforms after tryouts.

B. Uniforms are not to be worn at functions other than games and pepassemblies, unless authorized by the sponsor.

C. Uniforms must at all times be clean and pressed. Cheer shoes (clean) withankle socks must be worn at all times.

D. Cheerleaders are responsible for the cleaning, repairs, and, if necessary, thereplacement of the uniform.

E. Uniforms MAYNOT be altered in any way without permission from thesponsor.

F. Body markings, such as tattoos, or piercings, other than in the earlobes, maynot be visible while in uniform.

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G. All clothing worn to any event, practice, fundraisers, etc. must benonrestrictive. When in uniform, all cheerleaders must match completely.

H. Porn poms and megaphones will be furnished by the CheerleadingOrganization.

Cheerleaders must maintain and uphold the reputation oflago Junior High Schoolthrough their own conduct. You should always be courteous, polite and friendly toeveryone, not just your friends. Always smile!

9. CONDUCT DURING EVENTS

A. Always warm up before cheering at any event.B. Never build a stunt without a sponsor, coach, or another authorized adult

present.C. Other than parents, friends or boyfriends are not allowed during any

cheerleading events; i.e. practices, meetings, games, etc.D. CheerleadersMUST support the Bullpups above all other teams.E. No excessivemake-up or jewelry.F. No excessive exaggeration of dance steps in chants and cheers.G. Hair is to beworn neatly, and long hair is to be pinned back, away from the

face.H. Group and private discussions must be avoided as they reflect upon the

organization of the squad.1. There will be no sarcasm or mocking of others. Such action would reflect on

the school or your organizations. Cheerleaders are to conduct themselves asgood citizens at ALL TIMES.

J. All must focus one's attention on the game at all times.K. Only uniformed school organized groups will be allowed in the performing

area.L. At all games, cheerleaders should be at the stadium or gymnasium at the

designated times. Time is set by the head cheerleader or the sponsor.M. Cheerleadersmust always conduct themselves in a mature manner whether in

uniform or not. Absolutely no profanity, smoking, drinking of alcohol, or useof illegal drugs.

N. All cheers and chants shall be of positive and sportsmanlike manner.Cheerleaders will make every attempt to ignore or discourage negativeresponses at events and not become involved in such action themselves.

10. GAMESANDPEP ASSEMBLIES

A. Every cheerleader is required to cheer and participate at all games and pepassemblies unless excused by the sponsor.

B. Tardiness and failure to attend games, pep assemblies, and mandatorypractices for unexcused reasons will constitute probation or benching.

C. Attend school at least half a day in order to participate in any activity for thatday unless excused by the Principal.

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D. Cheerleaders must be eligible by academic standards in order to cheer at anyscheduled events.

E. Cheerleaders will ride the school vehicle to and from all games, unless theyreturn home with their parents, in which each of the parents must personallycontact the sponsor 24 hours in advance with written notice. Email is easiest.

11. DISCIPLINE PROCEDURES

A. Probation is a documented warning by the sponsorB. Benching is excusing the person from said events(s) for a specified time. The

cheerleader will not participate or travel with the squad.C. Suspension is removal for the semester.D. If a cheerleader misses a practice, the said cheerleadermay not participate in

that week's pep rally or in any new stunts at the football game. A demerit willbe issued for unexcused absences.

E. A cheerleader may be suspended from events for the following reasons:1. Excessive unexcused absences (3)2. Excessive tardiness (3)3. Failure to cooperate with the head cheerleader or sponsor4. Failure to abide by squad rules and regulations

F. A cheerleader may be dismissed from the squad for the following reasons:1. Excessive and irreconcilable disruptive influence on the squad,2. Conduct likely to bring the squad or team's reputation into disrepute,3. Cheerleader engages in conduct that violates the cheerleading policy,4. Repetitive violations with supporting documentation by the sponsor, or5. As otherwise deemed necessary by the sponsor

****If a cheerleader is dismissed from the squad, or quits the squad, for anyof the above stated reasons, the individual may not tryout for cheerleader atany given point in the future.

Conflicts with any situation will first be discussed between the sponsor and thecheerleader(s) concerned.

6. Only one (1) warning, documented, shall be issued7. Demerits will be given for every violation to the listed handbook and by

laws.8. With three (3) demerits, the cheerleader will be benched for one (1)

week of events (including pep rallies and game events). Punishmentswill be progressive; you will be benched for one week of events eachtime another demerit is added.

9. With seven (7) demerits a cheerleader will be suspended from the squadfor the semester.

G. A cheerleader is a representative of the student body and may be subject todisciplinary action for violation of school rules.

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Cheerleader/Parent Acknowledgement

I have read and understand the information supplied to me concerningthe cheerleading responsibilities and recognize the dedication that ittakes by not only the cheerleader, but the parents as well. I alsounderstand that there will be a cost of around $700-$900 for the uniformand $160 for camp.

2020-2021 Cheerleader Candidate Date

2020-2021 Cheerleader Candidate Parent Date

Transportation Permission Slip

As explained throughout the handbook, there are several events that thecheerleaders will attend. My child, _has my permission to travel with Miss Rolf or any designated BISDdriver, to and from any school related event for cheerleading purposesfor the current school year. I understand that if my child wishes to travelwith anyone else other than the designated BISD driver, a written noticemust be given to Miss Rolf in advance.

2020-2021 Cheerleader Parent Date

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~tLSUDDENCARDIACARREST (SCA)AWARENESSFORMThe Basic Facts onSudden Cardiac Arrest

Website Resources:American Heart Association:

Lead Author: Arnold Fenrich, MDand Benjamin Levine, MD

Additional Reviewers: UIL MedicalAdvisory Committee

Revised 2016

What is Sudden Cardiac Arrest?~ Occurs suddenly and often without

warning.~ An electrical malfunction (short­

circuit) causes the bottom chambersofthe heart (ventricles) to beatdangerously fast (ventriculartachycardia or fibrillation) anddisrupts the pumping ability of theheart.

~ The heart cannot pump blood to thebrain, lungs and other organs of thebody.

~ The person loses consciousness(passes out) and has no pulse.

~ Death occurs within minutes ifnottreated immediately.

What causes Sudden Cardiac ,Arres~ ,Inherited (passed on from family)conditions present at birth oftheheart muscle:Hypertrophic Cardiomyopathy -hypertrophy (thickening) of the leftventricle; the most common cause ofsudden cardiac arrest in athletes inthe U.S.

Arrhythmogenic Right VentricularCardiomyopathy - replacement ofpart of the right ventricle by fat andscar; the most common cause ofsudden cardiac arrest in Italy.

Marfan Syndrome - a disorder of thestructure of blood vessels that makesthem prone to rupture; oftenassociated with very long arms andunusually flexible joints.

Inherited conditions present at birthof the electrical system:Long QTSyndrome - abnormality inthe ion channels (electrical system) ofthe heart.

Catecholaminergic PolymorphicVentricular Tachycardia andBrugada Syndrome - other types ofelectrical abnormalities that are rarebut run in families.

Nonlnherited (not passed on from thefamily,but still present at birth)conditions:Coronary Artery Abnormalities -abnormality of the blood vessels that ~supply blood to the heart muscle. This ~is the second most common cause ofsudden cardiac arrest in athletes inthe U.S.

Aortic valve abnormalities - failureof the aortic valve (the valve betweenthe heart and the aorta) to developproperly; usually causes a loud heartmurmur.

Non-compaction Cardiomyopathy -a condition where the heart muscledoes not develop normally.

Wolff-Parkinson-White Syndrome -an extra conducting fiber is present inthe heart's electrical system and canincrease the risk of arrhythmias.

Conditions not present at birth butacquired later in life:Commotio Cordis - concussion of theheart that can occur from being hit inthe chest by a ball, puck, or fist.

Myocarditis - infection orinflammation of the heart, usuallycaused by a virus.

Recreational/Performance­Enhancing drug use.

Idiopathic: Sometimes the underlyingcause of the Sudden Cardiac Arrest isunknown, even after autopsy.

What are thesymptoms/warning signs ofSudden Cardiac Arrest?

Fainting/blackouts (especiallyduring exercise)

~ Dizziness~ Unusual fatigue/weakness~ Chest pain~ Shortness of breath

Nausea/vomitingPalpitations (heart is beatingunusually fast or skipping beats)Family history of sudden cardiacarrest at age < 50

ANYof these symptoms and warningsigns that occur while exercising maynecessitate further evaluation fromyour physician before returning topractice or a game.

What is the treatment torSudden Cardiac Arrest?Time is critical and an immediateresponse is vital.~ CALL911~ Begin CPR~ Use an Automated External

Defibrillator (AED)

What are ways to screen forSudden Cardiac Arrest?The American Heart Associationrecommends a pre-participation historyand physical including 14 importantcardiac elements.

The UlLPre-Participation PhvsicalEvaluation - Medical History formincludes ALL14 of these importantcardiac elements and is mandatoryannually.

1

What are the currentrecommendations for screeningyoung athletes?The University Interscholastic Leaguerequires use of the specificPreparticipation MedicalHistory formon a yearly basis. This process beginswith the parents and student-athletesanswering questions about symptomsduring exercise (such as chest pain,dizziness, fainting, palpitations orshortness of breath); and questionsabout family health history.

It is important to know if any familymember died suddenly during physicalactivity or during a seizure. It is alsoimportant to know if anyone in thefamily under the age of 50 had anunexplained sudden death such asdrowning or car accidents. Thisinformation must be provided annuallybecause it is essential to identify those atrisk for sudden cardiac death.

The University Interscholastic Leaguerequires the Preparticipation PhysicalExamination form prior to junior highathletic participation and again prior tothe 1st and 3rd years of high schoolparticipation. The required physicalexam includes measurement of bloodpressure and a careful listeningexamination of the heart, especially formurmurs and rhythm abnormalities. Ifthere are no warning signs reported onthe health history and no abnormalitiesdiscovered on exam, no additionalevaluation or testing is recommendedfor cardiac issues/concerns.

Are there additional optionsavailable to screen for cardiacconditions?Additional screening using anelectrocardiogram (ECG)and/or anechocardiogram (Echo) is readilyavailable to all athletes from theirpersonal physicians, but is notmandatory, and is generally notrecommended by either the AmericanHeart Association (AHA)or theAmerican Collegeof Cardiology (ACC).Limitations of additional screeninginclude the possibility (-10%) of "falsepositives", which leads to unnecessarystress for the student and parent orguardian as well as unnecessaryrestriction from athletic participation.There is also a possibility of "falsenegatives", since not all cardiacconditions will be identified byadditional screening.

When should a student athletesee a heart specialist?If a qualified examiner has concerns, areferral to a child heart specialist, apediatric cardiologist, is recommended.This specialist may perform a morethorough evaluation, including anelectrocardiogram (ECG),which is agraph of the electrical activity of theheart. An echocardiogram, which is anultrasound test to allow for directvisualization of the heart structure, mayalso be done. The specialist may alsoorder a treadmill exercise test and/or amonitor to enable a longer recording ofthe heart rhythm. None of the testing isinvasive or uncomfortable.

Can Sudden Cardiac Arrest beprevented just through properscreening?Aproper evaluation (PreparticipationPhysical Evaluation - Medical History)should find many, but not all, conditionsthat could cause sudden death in theathlete. This is because some diseasesare difficult to uncover and may onlydevelop later in life. Others can developfollowing a normal screening evaluation,such as an infection of the heart musclefrom a virus. This is why a medicalhistory and a review of the family healthhistory need to be performed on a yearlybasis. With proper screening andevaluation, most cases can be identifiedand prevented.

Why have an AED on site duringsporting eventsThe only effective treatment forventricular fibrillation is immediate useof an automated external defibrillator(AEO).AnAEOcan restore the heartback into a normal rhythm. AnAEOisalso life-saving for ventricularfibrillation caused by a blow to the chestover the heart (commotio cordis).

Texas Senate Bill7 requires that at anyschool sponsored athletic event or teampractice in Texas public high schools thefollowing must be available:

};> AnAEOis in an unlocked locationon school property within areasonable proximity to the athleticfield or gymnasium

};> Allcoaches, athletic trainers, PEteacher, nurses, band directors andcheerleader sponsors are certified incardiopulmonary resuscitation(CPR)and the use of the AEO.

};> Each school has a developed safetyprocedure to respond to a medicalemergency involving a cardiacarrest.

The American Academy of Pediatricsrecommends the AEOshould be placedin a central location that is accessibleand ideally no more than a 1 to 1 1 /2minute walk from any location and thata call is made to activate 911 emergencysystem while the AEOis being retrieved.

Student & Parent/GuardianSignaturesI certify that I have read andunderstand the above information.

Parent/Guardian Signature

Parent/Guardian Name (Print)

Oate

Student Signature

Student Name (Print)

Oate

2

Revised 2017

CONCUSSION ACKNOWLEDGEMENT FORMName of Student _

Definition of Concussion - means a complex pathophysiological process affecting the brain caused by a traumatic physical force orimpact to the head or body, which may: (A) include temporary or prolonged altered brain function resulting in physical, cognitive, oremotional symptoms or altered sleep patterns; and (B) involve loss of consciousness.

Prevention - Teach and practice safe play & proper technique.- Follow the rules of play.- Make sure the required protective equipment is worn for all practices and games.- Protective equipment must fit properly and be inspected on a regular basis.

Signs and Symptoms of Concussion - The signs and symptoms of concussion may include but are not limited to: Headache, appearsto be dazed or stunned, tinnitus (ringing in the ears), fatigue, slurred speech, nausea or vomiting, dizziness, loss of balance, blurry vi­sion, sensitive to light or noise, feel foggyor groggy,memory loss, or confusion.

Oversight - Each district shall appoint and approve a Concussion Oversight Team (COT). The COT shall include at least one physicianand an athletic trainer if one is employed by the school district. Other members may include: Advanced Practice Nurse, neuropsy­chologist or a physician's assistant. The COT is charged with developing the Return to Play protocol based on peer reviewed scientificevidence.

Treatment of Concussion - The student-athlete/cheerleader shall be removed from practice or participation immediately ifsuspected to havesustained a concussion. Every student-athlete/cheerleader suspected of sustaining a concussion shall be seen by a physician before they mayreturn to athletic or cheerleading participation. The treatment for concussion is cognitive rest. Students should limit external stimulation suchas watching television, playing video games, sending text messages, use of computer, and bright lights. When all signs and symptoms ofconcussion have cleared and the student has received written clearance from a physician, the student-athlete/cheerleader may begin theirdistrict's Return to Play protocol as determined by the Concussion Oversight Team.

Return to Play - According to the TexasEducation Code, Section 38.157:A student removed from an interscholastic athletics practice or competition (including per UIL rule, cheerleading) under Section 38.156maynot be permitted to practice or participate again following the force or impact believed to have caused the concussion until:(1) the student has been evaluated, using established medical protocols based on peer-reviewed scientific evidence, by a treating physicianchosen by the student or the student's parent or guardian or another person with legal authority to make medical decisions for thestudent;(2) the student has successfully completed each requirement of the return-to-play protocol established under Section 38.153necessaryfor the student to return to play;(3) the treating physician has provided a written statement indicating that, in the physician's professional judgment, it is safe for thestudent to return to play; and(4) the student and the student's parent or guardian or another person with legal authority to make medical decisions for the student:(A) have acknowledged that the student has completed the requirements of the return-to-play protocol necessary for the student to

return to play;(B) have provided the treating physician's written statement under Subdivision (3) to the person responsible for compliance with the

return-to-play protocol under Subsection (c) and the person who has supervisory responsibilities under Subsection (c); and(C) have signed a consent form indicating that the person signing:(i) has been informed concerning and consents to the student participating in returning to play in accordance with the return-to­

play protocol;(ii) understands the risks associated with the student returning to play and will complywith any ongoing requirements in the

return-to-play protocol;(iii) consents to the disclosure to appropriate persons, consistent with the Health Insurance Portability and Accountability Act of

1996 (Pub. L.No. 104-191), of the treating physician's written statement under Subdivision (3) and, if any,the return-to-play recommenda­tions of the treating physician; and

(iv) understands the immunity provisions under Section 38.159.

Parent or Guardian Signature Date

Student Signature Date

elL University Interscholastic League elLParent and Student Agreement/Acknowledgement Form

Anabolic Steroid Use and Random Steroid Testing

• Texas state law prohibits possessing, dispensing, delivering or administering a steroid in amannernot allowedby state law.

• Texas state law also provides that body building, muscle enhancementor the increase in musclebulk or strength through the use of a steroid by a person who is in good health is not a validmedicalpurpose.

• Texasstate law requires that only a licensedpractitionerwith prescriptiveauthority mayprescribea steroid for a person.

• Any violation of state law concerningsteroids is a criminal offense punishableby confinement injailor imprisonmentin the Texas Departmentof CriminalJustice.

STUDENTACKNOWLEDGEMENTANDAGREEMENT

As a prerequisiteto participation in UIL athletic activities, I agree that I will not use anabolic steroids asdefined in the UILAnabolicSteroid Testing ProgramProtocol. I have readthis form and understandthat Imay be asked to submit to testing for the presence of anabolic steroids in my body, and I do herebyagree to submit to such testing and analysis by a certified laboratory. I further understandand agree thatthe results of the steroid testing may be provided to certain individuals in my high school as specified inthe UIL Anabolic Steroid Testing Program Protocol which is available on the UIL website atWWW.uiltexas.org.I understandand agree that the results of steroid testing will be held confidential tothe extent required by law. I understand that failure to provide accurate and truthful information couldsubjectme to penaltiesas determinedby UIL.

StudentName(Print): Grade (9-12) _

StudentSignature: Date: _

Relationshipto student: _

PARENT/GUARDIANCERTIFICATIONANDACKNOWLEDGEMENT

As a prerequisiteto participationby my student in UIL athletic activities, I certify and acknowledgethat Ihave read this form and understand that my student must refrain from anabolic steroid use and may beasked to submit to testing for the presence of anabolic steroids in his/her body. I do hereby agree tosubmitmy child to such testing and analysisby a certified laboratory. I further understandand agree thatthe results of the steroid testing may be provided to certain individuals in my student's high school asspecified in the UIL Anabolic Steroid Testing ProgramProtocolwhich is available on the UIL website atwww.uiltexas.org.I understandand agree that the results of steroid testing will be held confidential tothe extent required by law. I understand that failure to provide accurate and truthful information couldsubjectmystudent to penaltiesas determinedby UIL.

Name(Print): _

Signature: Date: _

SchoolYear (to be completedannually) _