neuqua valley wildcats girl’s lacrosse · 2015-02-25 · neuqua valley wildcats girl’s lacrosse...

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Neuqua Valley Wildcats Girl’s Lacrosse 2015 will be our 14 th season and we expect it to be as exciting as ever. Girl’s lacrosse at Neuqua Valley High School has come a long way in a few short years… 2014 Varsity Record was 14-5 overall Upstate Eight Conference Champions Ranked 7 th in the State (5 th consecutive and 7 of the last 8 years ranking in the top 10) Reached Semi-Sectional Finals JV Record was 7-3 overall Hosted 48 teams at the Wildcat Classic 2013 Varsity Record was 15-4 overall Celebrated Senior Day in the NVHS Stadium Won Sectional for first time in NVHS history Upstate Eight Conference Champions Ranked 6 th in the State JV Record was 8-3 overall Hosted 48 teams at the Wildcat Classic Novice Record was 2-5-1 overall 2012 Varsity Record was 12-6 overall Reached semi-sectional finals Ranked 9 th in the State JV Record was 8-5 overall Hosted 48 teams at the Wildcat Classic Frosh/Soph Record was 8-2 overall 2011 Varsity Record was 14-2 overall Upstate Eight Conference Champions

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Page 1: Neuqua Valley Wildcats Girl’s Lacrosse · 2015-02-25 · Neuqua Valley Wildcats Girl’s Lacrosse 2015 will be our 14th season and we expect it to be as exciting as ever. Girl’s

Neuqua Valley Wildcats Girl’s Lacrosse

2015 will be our 14th season and we expect it to be as exciting as ever. Girl’s lacrosse atNeuqua Valley High School has come a long way in a few short years…

2014Varsity

Record was 14-5 overall Upstate Eight Conference Champions Ranked 7th in the State (5th consecutive and 7 of the last 8 years

ranking in the top 10) Reached Semi-Sectional Finals

JV Record was 7-3 overall Hosted 48 teams at the Wildcat Classic

2013Varsity

Record was 15-4 overall Celebrated Senior Day in the NVHS Stadium Won Sectional for first time in NVHS history Upstate Eight Conference Champions Ranked 6th in the State

JV Record was 8-3 overall Hosted 48 teams at the Wildcat Classic

Novice Record was 2-5-1 overall

2012Varsity

Record was 12-6 overall Reached semi-sectional finals Ranked 9th in the State

JV Record was 8-5 overall Hosted 48 teams at the Wildcat Classic

Frosh/Soph Record was 8-2 overall

2011Varsity

Record was 14-2 overall Upstate Eight Conference Champions

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Placed Second in Sectionals Played First ever game in NVHS Stadium

JV Record was 11-6 overall Hosted 44 teams at the Wildcat Classic

LACROSSE AND THE IHSA - “Waiting to Emerge”

The IHSA Board of Directors approved an Official State Series in boys and girls lacrossefor the Spring of 2014-2015 but only if at least 65 boys teams AND at least 40 girlsteams have officially entered the respective tournaments as of Dec 15, 2014. If eitherone of these thresholds is not met, neither tournament will be held.

We are now currently governed by the Illinois High School Women’s LacrosseAssociation (IHSWLA), which follows IHSA rules. The IHSWLA website is www.ihswla.org.

THE SEASON March through mid-June 2 to 2.5 hours practice 5-6 days/week, after school. Games are played any day (1.5 hours long). Number of games (approximately) Varsity: 14; JV: 10 - 12. Home field is Commissioner’s Park on 111th Street – just west of RT 59. Tournaments are usually played on Saturdays & Sundays, and may involve travel. Fabulous end-of-season banquet.

WE ARE A NO-CUT SPORT AND WE HAVE A TEAM FOR EVERY LEVEL OF PLAY!

FEESSince we are not yet a sanctioned sport, we do not get any money from the school. Thismeans all of our funding comes from parents, players and fundraising. Here is abreakdown of what your fees cover:

Field rental for three teams Transportation for most away gamesOfficials for home games InsuranceLeague fees and dues CoachesUniforms Tournament feesTrainers AwardsEquipment Concussion Impact Testing

TOTAL FEES TO JOIN……………………………………* $550 Due in Full by Feb. 15, 2015

BREAKDOWN OF FEES AND DUE DATES:Commitment Deposit……………………………………………..…….$200.00 due by Dec. 15, 20142nd Installment …………………………………….……………………..$175.00 due by Jan. 15, 2015

**$100.00 for second playerFinal Installment…………………………………………………….…..$175.00 due by Feb. 15, 2015LATE FEE OF $50 ADDED TO ANY UNPAID BALANCE AFTER Feb. 15, 2015*If pay entire fee by Dec 15, 2014, there will be a $25 discount. (no discount after thisdate)* $50 of the $550 is your uniform deposit. You will receive a refund at the end of theseason when you return your full, clean and well maintained uniform.

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** If there is more than one player per family, the second player’s fees are only $300 forthe season (this does include the $50 refundable uniform deposit).

NO REFUNDS OF ANY FEES AFTER FEBRUARY 15, 2015

Checks payable to: Neuqua Valley Girl’s Lacrosse

Send forms and payments to: Kelly Kowalski3024 Kelltowne Ct.Naperville, IL 60565Home: 630-778-0346Cell: 630-991-6288

EQUIPMENT NEEDED TO PLAY:

Mandatory Stick Goggles Mouth Guard (No Clear or White ones, always keep an extra) Solid Navy shorts (to be worn under kilt)

Optional Cleats (highly recommended) Solid white Under Armour/Jetwear top (only white can be worn under

your jersey) Solid navy Under Armour leggings (nice in cold weather)

HELPFUL WEBSITE SOURCES for basic information and rules:

www.momsguide.com/wlacrosse/wl4.htmlwww. IHSWLA.orgwww. laxrules.comwww.uslacrosse.org/TopNav2Right/Rule/WomensRules.aspxwww.uslacrosse.org (get your US Lacrosse ID at this site)

CHECKLIST OF FORMS THAT NEED TO BE TURNED IN BY FEB. 15, 2015

_____ Completed and signed Registration Form (signed by parent) – Include US Lacrosse number

_____ Completed and signed Medical Release & Liability Waiver Form (signed by parent)

_____ Signed Athletic and Activity Code Form (signed by parent and athlete)

_____ Signed Roster Information & Media Release Form (signed by parent)

_____ Signed Academic Release Form (signed by parent) (To be provided later. IHSA Rule changes arerequiring this document to be updated)

_____ Signed Drug Testing Form

_____Current Physical on file with school nurse and an ATTACHED copy to registration form.

_____ Payment in FULL of $550.00.

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GET READY FOR AN EXCITING SEASON!GO WILDCATS?

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NEUQUA VALLEY WOMEN’S LACROSSETentative Schedule

2014-2015

November 5 7:00 pm NV Lacrosse Information/Registration Meeting

December 15 NV Lacrosse $200 deposit dueBoathouse order due

January 15 NV Lacrosse $175 2nd installment due

February 15 NV Lacrosse $175 final installment due$50 late fee on any unpaid fees. NO REFUNDS after this date!!!

March – May Regular season games – Full schedule will be on website

March 2 – 3 Tryouts at Players Indoor Sports and NVHS outsidePlease see NVLAX website for additional times and places

March 4 Practice starts – All Players together

March 5 - 6 Practice – JV/Varsity split

March 6 7:00–9:00pm MANDATORY parent meeting & socialLocation TBD

March 27 – March 29 Varsity Spring Break Trip

April 1 – April 4 Spring Break (There will be practices and/or games)

April TBD Senior Night

May 2 Wildcat Classic Tournament – JV1 & JV2 Tournament onlyVarsity required to work the tournament

May 24 Neuqua Graduation

June 3 Last day of school

June 7 End of Season Banquet

TBD Uniform return/Paper Plate awards/BBQ

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2015 Neuqua Valley Girl’s Lacrosse Registration(PLEASE PRINT CLEARLY AND ATTACH A COPY OF YOUR PHYSICAL)

Player Name _______________________________________________ DOB ______________Grade ________________

School ID# _______________ Physical Date _______________ Copy of physical attached? _______Yes ________ No

Street Address ________________________________________ City _______________________ZIP_______________

Home Phone ____________________________ Cell Phone _______________________________T-shirt size _______

Subdivision ____________________________Player Email ________________________________________________

Measurements: Chest_________ Waist ________ Hips_________

U.S. Lacrosse ID: ____________________________

Lacrosse Experience (Position, Where, How long) ___________________________________________________________________________________________________________________________________________________________

Off-Season Play (List all lacrosse camps, clinics, leagues, tournaments) ________________________________________________________________________________________________________________________________________

Other Sports (Position, What, Where)___________________________________________________________________

Father’s Name _____________________________________ Email __________________________________________

Phone ____________________________________________ Cell Phone______________________________________

Mother’s Name _____________________________________ Email __________________________________________

Phone _____________________________________________Cell Phone______________________________________

I AM AWARE THERE WILL BE NO REFUNDS OF ANY FEES AFTER FEBRUARY 15, 2015.

Parent Signature _________________________________________________ Date _____________________

PARENT VOLUNTEER (PLEASE CHOOSE TWO)Please see next page for brief descriptions of these volunteer opportunities.

____Team Parent** ____Senior Night** ____Web Site____Social** ____Banquet** ____Game Pictures____Fundraising** ____Field Lining ____Game Videos____WCC Tournament** ____Publicity ____Team DVD**____Board Member ____Statistician

**________I am interested in being a chair or co-chair for one of the areas I have chosen.

---------------------------------------------------------------------------------------------------------------------------------------------------------------------Office use only

Date ________ Reg Form ________ Pmt1__________ Pmt 2__________ Pmt 3 __________ Phys. Form/exp.________

Medical/Liability ________ Athletic/Activities________ Roster/Media ________ Academic Release ________

Kilt # ________ Jersey # ________ Uniform Return/Refund ________

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Neuqua Valley Girl’s LacrosseContact Information 2015

_________________________________Team Email: [email protected]

Website: www.nvlax.com

CoachesKirstie ShermanPhone: [email protected]

We are still interviewing other strong candidates for the remaining opencoaches positions.

Parent Board

Michelle Metry Kelly KowalskiCell: 630-202-5693 Cell: [email protected] [email protected]

Mish Turner Renee TurnerCell: 630-660-1053 Cell: [email protected] [email protected]

Paul LetourneauCell: [email protected]

Team Trainer

Dr. Bill Buchar630-820-1330 Office630-607-4274 [email protected]

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NEUQUA VALLEY HIGH SCHOOL LACROSSE CLUBEMERGENCY MEDICAL RELEASE & LIABILITY WAIVER

Player’s Name:___________________________________________Birthdate:_________________________

Street Address:_______________________________________City:___________________Zip:___________

Players Cell:_______________Allergies:_________________________________________________________

Other Medical Conditions: ____________________________________________________________________

EMERGENCY INFORMATION

Father’s Name:_______________________________Phone:__________________Cell:__________________

Mother’s Name:______________________________Phone:__________________Cell:___________________

In case of emergency when parent/guardian cannot be reached, please contact the following:

Name: _______________________________________Phone: __________________Cell________________

Name: _______________________________________Phone: __________________Cell________________

MEDICAL INSURANCE INFORMATION

Physician: _______________________________________Phone: __________________________________

Medical/Hospital Insurance Company: _______________________________Phone: ____________________

Policy Holders Name: __________________________________Policy#________________________________

I the undersigned (if applicant/participant is 18 years of age or older) or parent/guardian of the above listed minor applicant/participantacknowledge and fully understand that each applicant/participant will be engaging in activities that involve risk of serious injury, includingpermanent disability or death and severe social and economic losses which might result not only from their own actions, inactions andnegligence but action, inaction or negligence of other, the rules of play or the conditions of the premises or of any equipment used and further,that there may be other unknown risks not reasonable, foreseeable at the time, assume all the foregoing risk and accept personal responsibilityfor the damages following such injury, permanent disability or death, hereby release, discharge, covenants to indemnify and not sue NeuquaValley High School Lacrosse Club, Illinois High School Women’s Lacrosse Association, their affiliated organizations and sponsors, theircoaches, managers, employees and associated personnel, officers, members of the Board of Directors, agents, including the owners andleasers of premises used to conduct the event, all of which are hereinafter referred to as “releasees,” from any and all liability to each of theundersigned, his/her heirs or next of kin for any and all against any claim by or on behalf of the applicant as a result of the applicant’sparticipation in the Programs and/or being transported to or from Programs. I hereby give my consent to have an athletic trainer, coach and/ordoctor of medicine or dentistry or associated personnel to provide the applicant/participant with medical assistance and/or treatment and agreeto be financially responsible for the cost of such assistance and/or treatment. I, also agree to save and hold harmless and indemnify each andall parties herein referred to above as release from all liability, loss, cost, claim or damage whatsoever, including death or damage to propertywhich may be imposed upon said releasee because of any defect in or lack or such capacity to so act or caused or alleged to be caused inwhole or in part by the negligence of the releasee. I have read the above waiver/release and understand that (I) we have given up substantialrights by signing this release and sign below voluntarily.

Parent/Guardian Signature____________________________________________Date_____________________

Printed Name ____________________________________________________

NOTE: THIS AUTHORIZATION FOR EMERGENCY MEDICAL TREATMENT MUST BE COMPLETEDBEFORE A PLAYER BEGINS PARTICIPATION. TREATMENT FOR INJURY WILL BE BASED ONINFORMATION PROVIDED HEREIN.

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2015 Roster Information & Media Release FormI give permission for the following information to be displayed in the rostersection on the Neuqua Valley Girl’s Lacrosse website for the 2014 season. Iunderstand that I can submit all the information, partial information, or noinformation. I further understand that pictures will be taken throughout theseason for use on the website and other media (i.e. newspapers, team DVDsetc.) and that I may revoke and/or prohibit the usage of my daughter’s photos atany time.

OK to post roster information? YES ___ NO ___OK to use photos on website? YES ___ NO ___OK to use photos in other media? YES ___ NO ___

Player First Name__________________ Last Name_____________________

Nick Name____________________ Birthplace__________________________

Birthdate _____________ Age__________ Graduation Year______________

Position___________________________________________ Number_______

Ambitions/Life Goals______________________________________________

Musical Taste____________________________________________________

Favorite Pastime__________________________________________________

Place most likely to be seen________________________________________

Favorite Quote/Words of Wisdom____________________________________

Awards/Recognitions______________________________________________

Other Activities___________________________________________________

PARENT SIGNATURE ________________________ Date________

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NVHS Girl’s Lacrosse - Parent Volunteer Positions

The Neuqua Valley Girl’s Lacrosse Club’s success is only possible with the support of all ourwonderful parents. There are many ways for you to be involved in helping the program throughout theseason. There are volunteer opportunities for you to choose from and other activities that require helpfrom each family.

Each family will be required to help with 3 – 4 home games by scoring or timing, first aid, orproviding ice. See descriptions below. Team parents will make assignments.

Each family will be required to either host one of 3 pasta parties or provide food, drinks, etc. asassigned by team parents.

Each family will be required to help with the Wildcat Classic Tournament on May 2. You maychoose to be a chairperson or work a shift. Various jobs to choose from. More information to follow.

Game DayScoring & Timing Score keeper or timer for home games; must arrive 15 minutes early to keep score

or run time clock during game.

First Aid Use team first aid kit to administer band-aids or ice packs as needed. No formaltraining necessary. Bring ice to game. Call 911 if needed or provide direction tolocal hospital.

Ice Provide ice to be used for injuries for home games.

Wildcat Classic We host the Wildcat Classic on May 2, 2015. This is a JV and Fr/So tournament andTournament ** will have over 40 teams from around the area participating. This is an important

fundraising event. Varsity players and parents from all teams are expected tohelp with this event.

Please select at least two areas you would be interested in helping with on the registration form.

Team Parent** Usually 2 per team. Help to organize volunteers for each team as needed forgames, pasta parties, and other team social activities and communicate as neededto parents and team members.

Social** Help plan and organize social events such as team sleepover, field trip, and end ofyear BBQ/Paper Plate Award party.

Fundraising** Help plan and organize coupon card fundraiser.

Senior Night** Plan and coordinate activities for senior night.

Banquet** Help coordinate end of season awards banquet for teams and parents. Work withfacility to plan event, send invitations, handle RSVP's, help coordinate awards.

Game Pictures Take pictures during games for use on team DVD or website.

Game Videos Take video of team play as requested by coach to use in training or for use onteam DVD.

Team DVD** Create team DVD for end of season.

Web Site Assist with website maintenance as needed.

Publicity Assist with varsity team publicity, providing game recaps and scores to localpapers.

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Board Member Participate in the activities to successfully run one of the most successful GirlsLacrosse programs in the Western Suburbs.

Statistician Learn how to take Women’s Lacrosse statistics. These statistics are listed on thehttp://www.ihswla.org/ web site, and is one of the categories used by coaches todetermine All Conference/State honors. This is a two person job; one to spot andanother to note each stat, and is required for every game.

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IHSA Sports Medicine Acknowledgement & Consent Form

Concussion Information Sheet A concussion is a brain injury and all brain injuries are serious. They are caused by a bump,

blow, or jolt to the head, or by a blow to another part of the body with the force transmitted to the

head. They can range from mild to severe and can disrupt the way the brain normally works.

Even though most concussions are mild, all concussions are potentially serious and may

result in complications including prolonged brain damage and death if not recognized

and managed properly. In other words, even a “ding” or a bump on the head can be serious.

You can’t see a concussion and most sports concussions occur without loss of consciousness.

Signs and symptoms of concussion may show up right after the injury or can take hours or days

to fully appear. If your child reports any symptoms of concussion, or if you notice the symptoms

or signs of concussion yourself, seek medical attention right away.

Symptoms may include one or more of the following:

Headaches

“Pressure in head”

Nausea or vomiting

Neck pain

Balance problems or dizziness

Blurred, double, or fuzzy vision

Sensitivity to light or noise

Feeling sluggish or slowed down

Feeling foggy or groggy

Drowsiness

Change in sleep patterns

Amnesia

“Don’t feel right”

Fatigue or low energy

Sadness

Nervousness or anxiety

Irritability

More emotional

Confusion

Concentration or memory problems (forgetting game plays)

Repeating the same question/comment

Signs observed by teammates, parents and coaches include:

Appears dazed

Vacant facial expression

Confused about assignment

Forgets plays

Is unsure of game, score, or opponent

Moves clumsily or displays incoordination

Answers questions slowly

Slurred speech

Shows behavior or personality changes

Can’t recall events prior to hit

Can’t recall events after hit

Seizures or convulsions

Any change in typical behavior or personality

Loses consciousness

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IHSA Sports Medicine Acknowledgement & Consent Form

Concussion Information Sheet (Cont.)

What can happen if my child keeps on playing with a concussion or returns too soon?

Athletes with the signs and symptoms of concussion should be removed from play immediately. Continuing to play with the signs and symptoms of a concussion leaves the young athlete especially vulnerable to greater injury. There is an increased risk of significant damage from a concussion for a period of time after that concussion occurs, particularly if the athlete suffers another concussion before completely recovering from the first one. This can lead to prolonged recovery, or even to severe brain swelling (second impact syndrome) with devastating and even fatal consequences. It is well known that adolescent or teenage athletes will often fail to report symptoms of injuries. Concussions are no different. As a result, education of administrators, coaches, parents and students is the key to student-athlete’s safety.

If you think your child has suffered a concussion

Any athlete even suspected of suffering a concussion should be removed from the game or practice immediately. No athlete may return to activity after an apparent head injury or concussion, regardless of how mild it seems or how quickly symptoms clear, without medical clearance. Close observation of the athlete should continue for several hours. IHSA Policy requires athletes to provide their school with written clearance from either a physician licensed to practice medicine in all its branches or a certified athletic trainer working in conjunction with a physician licensed to practice medicine in all its branches prior to returning to play or practice following a concussion or after being removed from an interscholastic contest due to a possible head injury or concussion and not cleared to return to that same contest. In accordance with state law, all IHSA member schools are required to follow this policy. You should also inform your child’s coach if you think that your child may have a concussion. Remember it’s better to miss one game than miss the whole season. And when in doubt, the athlete sits out.

For current and up-to-date information on concussions you can go to:

http://www.cdc.gov/ConcussionInYouthSports/

Adapted from the CDC and the 3rd

International Conference on Concussion in Sport Document created 7/1/2011 Reviewed 4/24/2013

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IHSA Sports Medicine Acknowledgement & Consent Form

IHSA Performance-Enhancing Substance Testing Policy

In 2008, the IHSA Board of Directors established the association’s Performance-Enhancing Substance (PES) Testing Program. Any student who participates in an IHSA-approved or sanctioned athletic event is subject to PES testing. A full copy of the testing program and other related resources can be accessed on the IHSA Sports Medicine website. Additionally, links to the PES Policy and the association’s Banned Drug classes are listed below. School administrators are able to access the necessary resources used for program implementation in the IHSA Schools Center. IHSA PES Testing Program http://www.ihsa.org/documents/sportsMedicine/2014-15/2014-15%20PES%20policy%20final.pdf IHSA Banned Drug Classes http://www.ihsa.org/documents/sportsMedicine/2014-15/2014-15%20IHSA%20Banned%20Drugs.pdf

IHSA Steroid Testing Policy Consent to Random Testing As a prerequisite to participation in IHSA athletic activities, we agree that I/our student will not use performance-enhancing substances as defined in the IHSA Performance-Enhancing Substance Testing Program Protocol. We have reviewed the policy and understand that I/our student may be asked to submit to testing for the presence of performance-enhancing substances in my/our student’s body either during IHSA state series events or during the school day, and I/our student do/does hereby agree to submit to such testing and analysis by a certified laboratory. We further understand and agree that the results of the performance-enhancing substance testing may be provided to certain individuals in my/our student’s high school as specified in the IHSA Performance-Enhancing Substance Testing Program Protocol which is available on the IHSA website at www.IHSA.org. We understand and agree that the results of the performance-enhancing substance testing will be held confidential to the extent required by law. We understand that failure to provide accurate and truthful information could subject me/our student to penalties as determined by IHSA. A complete list of the current IHSA Banned Substance Classes can be accessed at http://www.ihsa.org/documents/sportsMedicine/2014-15/2014-15%20IHSA%20Banned%20Drugs.pdf

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IHSA Sports Medicine Acknowledgement & Consent Form

Acknowledgement and Consent

Student/Parent Consent and Acknowledgements By signing this form, we acknowledge we have been provided information regarding concussions and the IHSA Performance-Enhancing Testing Policy. We also acknowledge that we are providing consent to be tested in accordance with the procedures outlined in the IHSA Performance-Enhancing Testing Policy.

STUDENT Student Name (Print): Grade (9-12) Student Signature: Date: PARENT or LEGAL GUARDIAN Name (Print): Signature: Date: Relationship to student:

Each year IHSA member schools are required to keep a signed Acknowledgement and Consent form and a current Pre-participation Physical Examination on file for all student athletes.

Consent to Self Administer Asthma Medication

As a patient under my care, , is prescribed to self-administer the following asthma medication.

Medication

Purpose

Dosage

Time/Special Circumstances

Printed Name of Physician Signature of Physician Date I, , do hereby give my son/daughter, , Permission to self-administer his/her asthma medication as prescribed by his/her physician during athletic competition. Printed Name of Parent/Guardian Signature of Parent/Guardian Date

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15

ATHLETIC AND ACTIVITY CODE OF CONDUCT 2014-15 NEUQUA VALLEY HIGH SCHOOL

ACTIVITIES ARE A PRIVILEGE The activities / athletics included in this Code place the student participants in the role of representatives of the high school and their fellow students. Participation is a privilege extended to these students, which permits them to benefit from a well-organized program of special interest for which the school provides coaches, sponsors, equipment, and facilities. No student has the right to participate in any of these activities or any other extracurricular/co-curricular activities. With the privilege of participation comes the additional responsibility of each participant to learn, understand, and follow the rules established by the District, the high school and the coaches/sponsors of the particular activity. Because these activities are voluntary and because those participating represent their school, we expect the behavior of those who try out and participate to be of the highest order. This is particularly true of academic requirements, honesty, school citizenship, and sportsmanship. The dignity of the school is reflected in its activity program. Since it is a privilege to participate and represent the school, it is logical that the school has the authority to revoke or restrict the privilege for those who do not conduct themselves in a responsible manner. This sense of responsibility extends to the activity as well as to conduct inside and outside the school. When the doors of participation and competition are opened to those who have questionable habits or who are not good citizens, the activity program can fail. The privilege of representing the school should be left in the hands of those who have earned it.

ACADEMIC ELIGIBILITY In order to be eligible to participate in any co-curricular activities, students must be in good academic standing as prescribed by the Board of Education in compliance with state law. Coaches and sponsors will review eligibility standards at the beginning of each season and as new members join the activity.

PARTICIPATION RULES Once a student begins participation in any program of athletics/activities at the high school, this Code will be in effect for the remainder of the student’s high school attendance in District 204, including summer months. The high school will attempt to make all participants aware of this Code and other rules established by coaches/sponsors. Information may be furnished at enrollment, initial participation in an activity and periodically in connection with other activities. However, the responsibility of learning, understanding and following this Code and other applicable rules lies with the student participant. Written acknowledgment of this Code by each participant will be sought, but will not be a prerequisite to enforcement of this Code or other rules.

HIGH SCHOOL PARTICIPATION In order to be eligible for participation in any school-sponsored or school-supported athletic or extracurricular activity, each student in grade 9, 10, 11 or 12 must maintain a passing grade in no less than (5) courses, as determined on a weekly basis. Any student who fails to meet the aforesaid requirement will be suspended from further participation in all school-sponsored and school-supported athletic and extracurricular activities for seven (7) calendar days.

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16

HIGH SCHOOL PARTICIPATION continued In addition, any student who fails to maintain a passing grade in no less than five (5) courses for a given semester will be prohibited from participating in any school-sponsored or school-supported athletic and extracurricular activities for the following semester. Participation in school-sponsored or school-supported athletic or extracurricular activities may also be subject to additional eligibility requirements imposed by the Illinois High School Association (IHSA) or other governing bodies. School-sponsored and school-supported athletic and extracurricular activities include, but are not limited to:

All activities sanctioned by the IHSA Poms and drill team All events of a competitive nature between two or more schools. The list of included activities will be periodically reviewed and updated by the

administration. Activities which are linked to a student’s grade will not be considered to be school-sponsored or school-supported athletic or extracurricular activities.

Performances (i.e. drama, Orchesis, co-curricular music, etc.), which are not linked to students’ grade, will be considered on a semester basis only.

PROCEDURE A student accused of a violation will be informed of the charge and given the opportunity to explain or respond.

a) For violations, which occur at school, or at school-sponsored events a school administrator/dean will be informed and will follow the normal school conduct code. With regard to the extra-curricular penalty, the administrator/dean will inform the Athletic/Activities Director, head coach/sponsor, and parents.

b) For reported violations, which occur outside of school or in the summer, the

Athletic/Activities Director will investigate and inform the head coach/sponsor, student, and parents. The Athletic/Activities Director will meet with the student and render a decision regarding Athletic/Activities participation.

APPEAL Since athletic/activity participation is a privilege, it is not protected by due process procedures applicable to regular public education. A participant may appeal the declaration of the ineligibility to the building principal. Such appeal must be submitted within 48 hours of the declaration. A parent must attend the appeal. The penalty remains in force during the appeal. The decision of the principal is final.

ACTIVITY PENALTIES During out-of-school suspensions, no practices or contests are allowed. In addition, the student may not be in practice or a contest if that conflicts with an assigned school penalty (e.g. P.M. detention, Saturday School).

CRIMINAL ACTION When the school has substantiated knowledge of criminal offense or that a student has been charged with a criminal offense, he/she will immediately be temporarily suspended from participation in all extracurricular activities. The high school administration and Athletic/Activities Director(s) will consider duration of the suspension and reinstatement of the student to a program based upon a review of the information.

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SUBSTANCE USE OR POSSESSION Schools have a significant interest in discouraging the use of prohibited substances to provide a safe and healthy environment conducive to learning. It is considered a violation of the athletic and activity code if a student is in the presence, possesses, uses, distributes, or sells illegal drugs, look-a-like drugs, paraphernalia, controlled substances, or alcoholic beverages, and if a student attends a party or gathering where alcohol or drugs are present and or being consumed. The following procedure will be used if a student who tries out or participates in athletics or activities is involved in an alcohol or drug-related situation. Voluntary Admission / 1ST Offense: A student may admit that he/she violated the code provisions regarding drugs and alcohol only one time in his/her high school career. The voluntary admission to the coach / sponsor / athletic or activities director must occur within the first 24 hours following the rule violation. The student may be required to attend an education program and / or the athletic/activities director may suspend the student from one or more contests/events. Failure to follow the recommendation may result in further suspension. Voluntary admission is not applicable if authorities respond to a gathering where alcohol or drugs are present and report to school officials, if a ticket is issued for attendance at, consumption/possession or names appear in the newspapers.

1st Offense: The student will be suspended 40% of athletic/activity scheduled competition. If the student completes an assessment program from a professional agency the suspension may be reduced to 20% of scheduled contests following the completion of the recommendations of the educational program/assessment, with documentation provided of completion of the program. During this suspension the student may practice but will not participate in contests/events. If the student does not complete the suspension or does not complete the assessment, the penalty will continue into the student’s next activity. It is the responsibility of the student to provide the athletic/activities director(s) with prompt evidence of the required assessment/evaluation/ recommended program before reinstatement of privilege. The student who does not obtain an assessment or participate in an approved program will be suspended for 40% of season. During this suspension, the student will not practice or compete/participate. 2nd Offense: The student will be suspended for one calendar year from participating in all school activities. It is the responsibility of the student to provide the athletic/activity director(s) with prompt evidence of the required assessment/evaluation and recommended program prior to reinstatement of athletic/activity privileges. 3rd Offense: The student will not participate or attend any school activity or event for the rest of his/her high school years (i.e. sport events, dances, and prom) until submitting substantial evidence of rehabilitation to the athletic activities director(s) to seek reinstatement of activity privileges.

STEROIDS AND PERFORMANCE ENHANCING SUPPLEMENTS (IHSA Performance-

Enhancing Drug Testing Policy)

In accordance with the work of its Sports Medicine Advisory Committee and Public Act 096-0132, the Illinois High School Association shall implement a performance-enhancing substance testing program for student-athletes at IHSA member schools. The Illinois Department of Public Health shall provide oversight to the association and the testing program as needed.

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STEROIDS AND PERFORMANCE ENHANCING SUPPLEMENTS (IHSA Performance-

Enhancing Drug Testing Policy) continued

The value of high school interscholastic programs is found in the over-all physical, emotional, and intellectual development of student athletes. In that pursuit, anabolic steroids and performance-enhancing dietary substances offer no positive contribution. Rather, their use jeopardizes not only the health of student-athletes, but also impedes in their over-all development. And since this use runs counter to the purpose and value of interscholastic programs, coaches, administrators, school officials or employees, or booster club/support group members have an obligation and responsibility to provide only healthy, safe, and approved substances to student-athletes. For a complete list of resources, interested individuals can access the IHSA Sports Medicine Advisory Committee on Special Topics page at http://www.ihsa.org/initiatives/sportmed/index.htm. August 2009, Illinois Governor Pat Quinn signed into law Public Act 096-0132, which expanded the association ín drug testing efforts. The measure allows for not only an increase in the number of administered tests, but also allows for testing throughout the school year and not just during selected state series competitions. General Prohibitions 1. It shall be considered a violation of the IHSA By-law 2.170 and its subsections for any student-athlete to ingest, or otherwise use any substance of the IHSA Banned Substance Classes, without a written prescription and medical documentation provided by a licensed physician who evaluated the student-athlete for legitimate medical condition. 2. Violations found as a result of the IHSA Performance-Enhancing Substance Testing program shall be penalized in accordance with this policy. 3. Violations found as a result of any other drug or substance testing conducted by a member school shall be penalized in accordance with the member school athletic code of conduct policy. Banned Substances A complete posting of the current year banned substance classes list can be accessed at: http://www.ihsa.org/initiatives/sportsMedicine/files/IHSA_banned_drug_classes.pdf No student-athlete may participate in IHSA competitions unless the student and the student’s parent/guardian consent to random testing.

TOBACCO It is a violation of this code to use or be in possession of tobacco or smokeless tobacco products.

1st Offense: The student will be suspended from 10% athletic/activity contests/events. 2nd Offense: The student will be suspended for 20% of scheduled contests, which could result in the consequence being served over two seasons. The student will participate in all practices and attend contest during the time they are serving the consequence. It is the responsibility of the student to provide the athletic activity director(s) with evidence of completion of the required education program, before reinstatement of privilege. 3rd Offense: The student will be suspended for one calendar year from participating in all student athletic/activities. It is the responsibility of the student to provide the athletic/activity director(s) with evidence of completion of the required education program. 4th Offense: The student will not participate in any school activity or events for the rest of his/her high school years (i.e. sport events, dances, and prom) until submitting substantial evidence of rehabilitation to the athletic/activities director(s) to seek reinstatement of athletic/activity privileges.

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HAZING/CYBERBULLYING/HARASSMENT/BULLYING Hazing/harassment/bullying/cyberbullying in any athletic/activity program or outside the program is unacceptable. Students involved in hazing/harassment/ bullying/cyberbullying may be suspended from athletic/activity contest/events or removed from team. If a student is unsure of a behavior or practice, a building administrator can clarify.

HEALTH AND SAFETY 1. All athletes MUST have on file a current physical exam certificate that

will not expire within the season in order to practice or participate. 2. All athletes must show evidence of being covered by a health insurance

plan. Students must show proof of insurance at registration by submitting insurance company name and policy # or by enrolling in the school insurance plan.

3. If the Athletic/Activity Director has reasonable cause to believe a student's health condition may pose a risk to the student or others in the activity, he / she may require a more current certification of fitness to participate from a physician.

SCHOOL ATTENDANCE, MEDICAL EXCUSES and VACATIONS

1. Daily school attendance, no less than five (5) academic classes, is required for a student to participate in daily practice, contest or events. Exception can only be made by the activity/athletic director(s). It will not be the practice for participants to purposely miss part of a school day. Documentation of medical appointments, college visits, court appearance, must be provided to the coach, athletic/activity director(s) prior to participation of practice, or contest/event.

2. Athletes who are medically excused from regular physical education

classes may not participate in school activities, practices, or games without a doctor's release or a release from the school nurse. However, participation in athletics for such students may be limited by the school based on the safety judgment of the Athletic Director after consultation with the coach.

4. Participation in regular season practices is important for the safety and

health of students. Absence from such practices for vacations will be considered by the coach in restricting participation. However, absences due to illness will be considered in a different light and will be subject to individual review by the athletic/activity director with advice from the head coach in perspective of what is best for the student participant and school.

5. Vacation absences during an activity or team season can result in

restricted participation or release from the team/activity. See the individual coach/sponsor at the start of the sport/activity for details about absences.

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FUNDRAISING Indian Prairie District 204 has a strict policy (BP 7:325) on student participation in fundraising activities. In conjunction with the current fundraiser, we would like to inform you of the major points of that policy.

• Participation in or donation to any fundraising activity is always optional. • Each fundraising activity may establish a suggested donation as an alternative

to participation. • Under no circumstances will any student be compelled to participate or

donate, or penalized for not participating or donating. • Door-to-door solicitation is not required by any fundraising activity and is

discouraged. • If you have any questions or concerns about a fundraising activity, please

contact the sponsor, athletic director or the building administrators. • Thank you for your continued support.

SPORTSMANSHIP MISSION STATEMENT Good sportsmanship is the attitude and behavior that exemplifies positive support for the interscholastic programs of the IHSA member schools, as well as for the individuals who participate in such programs. People involved in all facets of the interscholastic program are expected to demonstrate respect for others and display good sportsmanship.

SPORTSMANSHIP IS EVERYBODY’S RESPONSIBILITY Sportsmanship starts on the court or athletic field and extends into the bleachers and beyond. In today's increasingly competitive environment, the thrill of victory and the agony of defeat seem to be more intensified than ever before. It is important to raise the public awareness of sportsmanship and interscholastic activities. It is everyone's responsibility to practice good sportsmanship. Recognizing the efforts by students, coaches, administrators, spirit groups, and fans is a valuable part of the interscholastic experience.

ADMINISTRATIVE DISCRETION Because participation in athletics/activities is a privilege, this Code is merely a guide for responding to certain identified actions or conduct. Not every situation involving conduct inconsistent with a student participant’s status as a representative of the high school is or can be covered. The high school reserves the right, but not the obligation, to alter, revise, adjust, or increase sanctions and discipline on a case-by-case basis, as the interests of the school require.

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New NCAA Division I Initial-Eligibility Standards

The initial-eligibility standards for NCAA Division I college-bound student-athletes are changing. College-bound student-athletes first entering a Division I college or university on or after August 1, 2016, will need to meet new academic rules in order to receive athletics aid (scholarship), practice or compete during their first year.

First, here are three terms you need to know:

Full Qualifier: A college-bound student-athlete may receive athletics aid (scholarship), practice and compete in the first year of enrollment at the Division I college or university.

Academic Redshirt: A college-bound student-athlete may receive athletics aid (scholarship) in the first year of enrollment and may practice in the first regular academic term (semester or quarter) but may NOT compete in the first year of enrollment. After the first term is complete, the college-bound student-athlete must be academically successful at his/her college or university to continue to practice for the rest of the year.

Nonqualifier: A college-bound student-athlete cannot receive athletics aid (scholarship), cannot practice and cannot compete in the first year of enrollment.

Here are the new requirements:

Full Qualifier must:

1. Complete 16 core courses (same distribution as in the past – click here to view);

� Ten of the 16 core courses must be completed before the seventh semester (senior year) of high school.

o Seven of the 10 core courses must be English, math or science.

2. Have a minimum core-course GPA of 2.300;

� Grades earned in the 10 required courses required before the senior year are “locked in” for purposes of GPA calculation.

o A repeat of one of the “locked in” courses will not be used to improve the GPA if taken after the seventh semester begins.

3. Meet the competition sliding scale requirement of GPA and ACT/SAT score (this is a new scale with increased GPA/test score requirements); and

4. Graduate from high school.

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New NCAA Division I Initial-Eligibility StandardsPage No. 2_________ Academic Redshirt must:

1. Complete 16 core courses (same distribution as in the past – click here to view);

2. Have a minimum core-course GPA of 2.000;

3. Meet the academic redshirt sliding scale requirement of GPA and ACT/SAT score; and

4. Graduate from high school.

Nonqualifier is a college-bound student-athlete who fails to meet the standards for a qualifier or for an academic redshirt.

CLICK HERE TO VIEW THE NEW RULES AND SLIDING SCALES.

Examples:

Q: A college-bound student-athlete completes 15 core courses with a 2.500 core-course GPA and an 820 SAT score (critical reading and math). What is the college-bound student-athlete’s NCAA initial-eligibility status?

A: The college-bound student-athlete is a nonqualifier because only 15 core courses were completed, not the required 16 core courses.

Q: A college-bound student-athlete completes 16 core courses in the required framework with a 2.500 core-course GPA and a 68 sum ACT. What is the college-bound student-athlete’s initial-eligibility status?

A: The college-bound student-athlete is an academic redshirt. Under the new competition scale, a 68 sum ACT score requires a 2.950 core-course GPA.

Q: A college-bound student-athlete completes nine core courses prior to the seventh semester of high school. What is the college-bound student-athlete’s initial-eligibility status?

A: The college-bound student-athlete cannot be certified as a qualifier because only

nine of the 10 required courses were completed before the seventh semester.

He/she would be permitted to practice and receive aid (scholarship), provided

he/she presents 16 core courses and meets the necessary core-course GPA and

test-score requirement at the time of graduation.

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2014-2015NEUQUA VALLEY ATHLETIC AND ACTIVITY CODE

I HAVE READ AND UNDERSTAND THE ATHLETIC AND ACTIVITY CODE FORNEUQUA VALLEY HIGH SCHOOL AND THE I.H.S.A. ELIGIBILITY RULES. AS ACONDITION OF PARTICIPATION, I AGREE TO ABIDE BY THEM AND SIGN BELOW.(See Athletic/Activity Director for clarification if unsure.)

_____________________________ ___________________________Date Student signature

_____________________________ ___________________________Activity or Sport Parent signature

_____________________________Sponsor / Coach

This sheet must be turned in -- signed -- to the Athletic / Activities Director.Any falsification of signatures on any athletic form may result in athleticsuspension for the student athlete.

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NEUQUA VALLEY WOMEN’S LACROSSEExpectations and Policies

EXPECTATIONS

A POSITIVE ATTITUDE is essential to our success.

It is expected that all student-athletes will WORK HARD, respect each other, and be a positive influence ontheir teammates.

On and Off-field, student-athletes will ABIDE BY SCHOOL POLICY

All student-athletes are expected to MAINTAIN A HEALTHY LIFESTYLE including an appropriate diet for theirlevel of activity and to get an appropriate amount of sleep.

EFFECTIVE TIME MANAGEMENT is expected for each student-athlete in order to avoid unnecessaryconflicts.

All practice and FIELD SPACE SHOULD BE KEPT TIDY. Taking care of one’s space shows you take greatpride in taking care of the details. Additionally, parents, staff and maintenance crews are not your servants;you dirty it up, it is YOUR RESPONSIBILITY to clean it up.

A POSITIVE SPORTING ATTITUDE will be displayed on and off the field to opponents, coaches, referees,parents, and spectators.

Players are asked to GIVE 100% TOTAL EFFORT in the classroom, on the field, and in the community.

Athletes will strive to KEEP PRIORITIES IN ORDER – Family, Academics, and Athletics. During events andpractice, athletes are expected to put the team first.

TEAMMATE 1st, Friend 2nd

POLICIESFailure to follow the standards can result in disciplinary action by the coach including but not limited to 1)Team Runs, You blow the whistle, 2) Suspension from Games/Team, 3) Dismissal from team

PUNCTUALITY: All students are expected to attend and be on time for all games, meetings, trips, practices,fundraising activities, etc. ANY tardiness or absence needs to be communicated ahead of time to the NV staffin person or by phone by the athlete, not parents.

COMMUNICATION: if issues arise, the student-athlete is expected to communicate directly with the coachingstaff; not through her parents.

Student-athletes shall refrain from any use of alcohol, drugs, and tobacco. It is not only illegal for your age, butit prevents the TEAM from reaching its potential. All student-athletes will abide by the Neuqua Valley HighSchool Athletic and Activity Code that they have signed.

Refrain from use of foul language – on and off of the field. Students are expected to communicate in a positive,respectful, honest manner at all times.

24 hr rule. If you have a problem with something a teammate or coach has said, you have 24 HOURS to beupset and deal with it. In this 24 hr period you have 2 choices: Deal with the problem and discuss it with whom it pertains to, then move on. Get over it and move on. At the end of 24 hours, there is no more dwelling on it or complaining about it

PLAYERS Signature: ______________________________ DATE:__________________

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Pre-participation Examination

To be completed by athlete or parent prior to examination.

Name School Year Last First Middle

Address City/State

Phone No. Birthdate Age Class Student ID No.

Parent’s Name Phone No.

Address City/State

HISTORY FORM Medicines and Allergies: Please list all of the prescription and over-the-counter medicines and supplements (herbal and nutritional) that you are currently taking Do you have any allergies? Yes No If yes, please identify specific allergy below. Medicines Pollens Food Stinging Insects

Explain “Yes” answers below. Circle questions you don’t know the answers to. GENERAL QUESTIONS Yes No

1. Has a doctor ever denied or restricted your participation in sports for any reason?

2. Do you have any ongoing medical conditions? If so, please identify below: Asthma Anemia Diabetes Infections Other: _ __________

3. Have you ever spent the night in the hospital?

4. Have you ever had surgery?

HEART HEALTH QUESTIONS ABOUT YOU Yes No

5. Have you ever passed out or nearly passed out DURING or AFTER exercise?

6. Have you ever had discomfort, pain, tightness, or pressure in your chest during exercise?

7. Does your heart ever race or skip beats (irregular beats) during exercise?

8. Has a doctor ever told you that you have any heart problems? If so, check all that apply: High blood pressure A heart murmur High cholesterol A heart infection Kawasaki disease Other: ___ ______

9. Has a doctor ever ordered a test for your heart? (For example, ECG/EKG, echocardiogram)

10. Do you get lightheaded or feel more short of breath than expected during exercise?

11. Have you ever had an unexplained seizure?

12. Do you get more tired or short of breath more quickly than your friends during exercise?

HEART HEALTH QUESTIONS ABOUT YOUR FAMILY Yes No

13. Has any family member or relative died of heart problems or had an unexpected or unexplained sudden death before age 50 (including drowning, unexplained car accident, or sudden infant death syndrome)?

14. Does anyone in your family have hypertrophic cardiomyopathy, Marfan syndrome, arrhythmogenic right ventricular cardiomyopathy, long QT syndrome, short QT syndrome, Brugada syndrome, or catecholaminergic polymorphic ventricular tachycardia?

15. Does anyone in your family have a heart problem, pacemaker, or implanted defibrillator?

16. Has anyone in your family had unexplained fainting, unexplained seizures, or near drowning?

BONE AND JOINT QUESTIONS Yes No

17. Have you ever had an injury to a bone, muscle, ligament, or tendon that caused you to miss a practice or a game?

18. Have you ever had any broken or fractured bones or dislocated joints?

19. Have you ever had an injury that required x-rays, MRI, CT scan, injections, therapy, a brace, a cast, or crutches?

20. Have you ever had a stress fracture?

21. Have you ever been told that you have or have you had an x-ray for neck instability or atlantoaxial instability? (Down syndrome or dwarfism)

22. Do you regularly use a brace, orthotics, or other assistive device?

23. Do you have a bone, muscle, or joint injury that bothers you?

24. Do any of your joints become painful, swollen, feel warm, or look red?

25. Do you have any history of juvenile arthritis or connective tissue disease?

MEDICAL QUESTIONS Yes No

26. Do you cough, wheeze, or have difficulty breathing during or after exercise?

27. Have you ever used an inhaler or taken asthma medicine?

28. Is there anyone in your family who has asthma?

29. Were you born without or are you missing a kidney, an eye, a testicle (males), your spleen, or any other organ?

30. Do you have groin pain or a painful bulge or hernia in the groin area?

31. Have you had infectious mononucleosis (mono) within the last month?

32. Do you have any rashes, pressure sores, or other skin problems?

33. Have you had a herpes or MRSA skin infection?

34. Have you ever had a head injury or concussion?

35. Have you ever had a hit or blow to the head that caused confusion, prolonged headache, or memory problems?

36. Do you have a history of seizure disorder?

37. Do you have headaches with exercise?

38. Have you ever had numbness, tingling, or weakness in your arms or legs after being hit or falling?

39. Have you ever been unable to move your arms or legs after being hit or falling?

40. Have you ever become ill while exercising in the heat?

41. Do you get frequent muscle cramps when exercising?

42. Do you or someone in your family have sickle cell trait or disease?

43. Have you had any problems with your eyes or vision?

44. Have you had any eye injuries?

45. Do you wear glasses or contact lenses?

46. Do you wear protective eyewear, such as goggles or a face shield?

47. Do you worry about your weight?

48. Are you trying to or has anyone recommended that you gain or lose weight?

49. Are you on a special diet or do you avoid certain types of foods?

50. Have you ever had an eating disorder?

51. Have you or any family member or relative been diagnosed with cancer?

52. Do you have any concerns that you would like to discuss with a doctor?

FEMALES ONLY Yes No

53. Have you ever had a menstrual period?

54. How old were you when you had your first menstrual period?

55. How many periods have you had in the last 12 months?

Explain “yes” answers here

I hereby state that, to the best of my knowledge, my answers to the above questions are complete and correct.

Signature of athlete Signature of parent/guardian Date ©2010 American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine. Permission is granted to reprint for noncommercial, educational purposes with acknowledgment. HE0503

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Pre-participation Examination PHYSICAL EXAMINATION FORM Name Last First Middle

EXAMINATION Height Weight Male Female BP / ( / ) Pulse Vision R 20/ L 20/ Corrected Y N

MEDICAL NORMAL ABNORMAL FINDINGS

Appearance • Marfan stigmata (kyphoscoliosis, high-arched palate, pectus excavatum,

arachnodactyly, arm span > height, hyperlaxity, myopia, MVP, aortic insufficiency)

Eyes/ears/nose/throat

Pupils equal

Hearing

Lymph nodes

Heart a

Murmurs (auscultation standing, supine, +/- Valsalva)

Location of point of maximal impulse (PMI)

Pulses

Simultaneous femoral and radial pulses

Lungs

Abdomen

Genitourinary (males only)b

Skin

HSV, lesions suggestive of MRSA, tinea corporis

Neurologic c

MUSCULOSKELETAL

Neck

Back

Shoulder/arm

Elbow/forearm

Wrist/hand/fingers

Hip/thigh

Knee

Leg/Ankle

Foot/toes

Functional

Duck-walk, single leg hop

aConsider ECG, echocardiogram, and referral to cardiology for abnormal cardiac history or exam.

bConsider GU exam if in private setting. Having third party present is recommended.

cConsider cognitive evaluation or baseline neuropsychiatric testing if a history of significant concussion.

On the basis of the examination on this day, I approve this child’s participation in interscholastic sports for 395 days from this date. Yes No Limited Examination Date Additional Comments: Physician’s Signature Physician’s Name Physician’s Assistant Signature* PA’s Name Advanced Nurse Practitioner’s Signature* ANP’s Name

*effective January 2003, the IHSA Board of Directors approved a recommendation, consistent with the Illinois School Code, that allows Physician’s Assistants or Advanced Nurse Practitioners to sign off on physicals.