Eisenhower Middle School Coaching Handbook

Similar documents
St. Francis Middle School Ski/Snowboard Club Grades 7-8

STUDENT WELFARE CONCUSSION MANAGEMENT

St. Francis High School Ski/Snowboard Club

2018 SPRING/SUMMER TACKLE FOOTBALL WAIVER FORM

Concussion Protocol Website

MANSFIELD PUBLIC SCHOOLS HEAD INJURY PROTOCOL

*Ages 8-18 years old. *Must be 12 years old to spend the night

Head Injury and Concussion Policy

Watervliet City School District Concussion Management Procedure

WILSON CREEK SCHOOL DISTRICT SPORTS PACKET

QUINCY PUBLIC SCHOOLS CONCUSSION POLICY GRADES 6-12 Revision Approved 10/5/2016

Role of Participants in the Management of Student Concussions & Other Head Injuries

MONROE WOODBURY CENTRAL SCHOOL DISTRICT CONCUSSION PROTOCOL

Revised: 9/8/08; 11/23/15; 11/20/ of 5

INTRAMURAL SPORTS RULES AND REGULATIONS

References Connecticut Public Act 14-66, An Act Concerning Youth Athletics and Concussions

Santa Margarita Catholic High School Girl s Soccer

Traumatic Brain Injury in the Defense Department

WINNIPEG SCHOOL DIVISION CONCUSSION PROTOCOL

SAYREVILLE WAR MEMORIAL HIGH SCHOOL PERMISSION TO PARTICIPATE IN ATHLETICS (PLEASE PRINT (NEATLY) EXCEPT WHERE SIGNATURES ARE REQUIRED)

4. In most schools the plan should be that a witness calls the front office ASAP, and staff there will:

Spiritus Sanctus Docebit Vos! The Holy Spirit will teach you!

EMERGENCY PROCEDURES MANUAL GEORGE MASON UNIVERSITY SPORTS MEDICINE

OUR LADY OF THE ASSUMPTION SCHOOL ATHLETIC PROGRAM GUIDELINES GENERAL INFORMATION

Membership Application *One form per applicant*

Langston University Returning Athlete Screening Form

JOB DESCRIPTION PATERSON BOARD OF EDUCATION. DIRECTORS AND MANAGERS 1692b DIRECTOR OF PHYSICAL EDUCATION, HEALTH, ATHLETICS AND NURSING Page 1 of 10

ALABAMA INDEPENDENT SCHOOL ASSOCIATION MEDICAL HISTORY FORM

Athletic Department Policies & Procedures

The Charge Person should be the one that is most qualified in First Aid and emergency procedures. This individual will:

Baseball. Clarion University. Clarion University Summer Baseball Camps. Mike Brown Head Baseball Coach Clarion University of Pennsylvania

FLAT ROCK WARRIORS FOOTBALL REGISTRATION

Per South Carolina High School League rules, pre-participation physicals are valid from April 1, 2017 May 31, 2018.

Alexander Bands. o Required forms packet (Medical Form, Code of Conduct, Drug Testing Awareness, Attendance Policy, Video/Photo Permission)

Mauldin Police Youth Academy Enrollment Application

Qualification criteria for the Cox High School Athletic Booster Club Scholarship are:

Implementing Return-to-Learn (Concussion Monitoring)

Students Controlled drugs means those drugs as defined in Conn. Gen. Stat. Section 21a-240.

Intramural Sports Participant Guide

First Aid Policy and Procedure February 2016

Auburn University Campus Recreation

Rhode Island College Club Sports Emergency Information Form

First Aid Policy and Procedure August 2017

West Campus High School th Street, Sacramento, CA 95820


KING S HOUSE SCHOOL FIRST AID & MEDICINES AND MEDICAL CONDITIONS MANAGEMENT POLICY

EMERGENCY ACTION PLAN

EASTERN MIDDLE SCHOOL POLICIES AND PROCEDURES

Components of the Emergency Action Plan

To be completed by healthcare provider

Fennville Public Schools Emergency Response Program GUIDELINES

East Tipp Middle School

First Aid Policy

B. Pre-planning and follow-up activities must occur in conjunction with all field trips.

Scholarship ADULT TIGER CLUB SCHOLARSHIP. Dollar Amount: $ Telephone: Ext Deadline for Submitting: Requirements:

TECUMSEH PUBLIC SCHOOLS Medical Emergency Response Team (MERT)

WELCOME COACHES! 2015 Spring Coaches Meeting

LIMESTONE COUNTY SCHOOLS EMERGENCY MANAGEMENT GUIDE

HILLIARD OPTIMIST CLUB SCHOLARSHIP APPLICATION GUIDELINES AND PROCEDURES

Kairos Retreat Policies & Permission Forms Bring home to Parents TODAY!

First Aid Policy. This Policy should be used in conjunction with the DEECD Student Health reference.

I consent to medical treatment for the student following an injury or illness suffered during practice and/or a contest.

Auburn University Campus Recreation

Commack School District District-Wide. Emergency Response Plan

First aid policy (Whole School including EYFS)

Hampton University Emergency Action Plan

BY-LAWS OF THE INTERFRATERNITY COUNCIL UNIVERSITY OF FLORIDA

Hampton Roads Regional Schools Life-Threatening Allergy Management Protocol Forms

EGUSD EMERGENCY INFORMATION

Club Sports Handbook

Scope These guidelines apply to all St Thomas the Apostle staff members and contractors whilst performing duties on behalf of the school.

Viterbo University & Western Technical College Intramural Handbook

Frank Augustus Miller Middle School. Color Guard Team

Clarion University Athletic Camps. Featuring 2010 PSAC Coach of the Year Rob Eaton

Season. Invitational/Practice Schedules Online: orwww. nphsathletics.sportngin.com

The Bethel Student Association Clubs and Organizations Manual

The City of Yucaipa S.T.A.R.S. BEFORE/AFTER SCHOOL 2017/2018 PARENT HANDBOOK

Lower Merion School District Policy No.: 916. Date Adopted: 2/28/11 Date Last Revised:

Islands High School Sharks Athletics. Booster Club. Monday, September 19 th. 6:00pm

The City of Yucaipa S.T.A.R.S. BEFORE/AFTER SCHOOL 2018/2019 PARENT HANDBOOK

At least four (4) - $1000 scholarships will be awarded to at least two male and two female recipients.

1 st CONTACT in case of emergency/concern: Relationship: PHONE NUMBERS: Home: Cell: Work:

SICK CHILD AND FIRST AID POLICY

Hull Collaborative Academy Trust. Medical Policy

October Rules Education. Olympic Sports October 9, 2014

From: Leonard M. Lee, Division Director of Violence and Injury Prevention

Handbook for Club Presidents and RYLA Chair Persons Rotary District Dave Stuckey, Chair

East Baton Rouge Parish School System Information Pertaining to All Salary Schedules

RIVER EDGE BOARD OF EDUCATION FILE CODE: 5141 River Edge, NJ 07661

National Honor Society Discipuli cum Laude chapter Bettendorf High School. Member Handbook School year

SUPPORTING CHILDREN AND STUDENTS WITH PREVALENT MEDICAL CONDITIONS ASTHMA ENSURING ASTHMA FRIENDLY SCHOOLS RYAN S LAW POLICY CODE: J 5.

SECTION 8: TEAM MANAGEMENT

FIRST AID POLICY SCOPE OBJECTIVES GUIDANCE. Policy owner. Reviewed on February Review by date January Audited by Governor Committee

STUDENT-ATHLETE GENERAL ELIGIBILITY CERTIFICATION

BROOKLYN TECHNICAL HIGH SCHOOL

Wynne Public Schools P.O. Box 69 Wynne, Arkansas Seizure Care In The School

Stephen F. Austin State University. Old / Returning Athlete

2.. The two persons trained shall be regular members of the school staff, which ensures at least one of the two being present during school hours.

CHEYNEY UNIVERSITY OF PENNSYLVANIA PUBLIC INFRACTIONS DECISION AUGUST 21, 2014

SCHOOL CRISIS, EMERGENCY MANAGEMENT, AND MEDICAL EMERGENCY RESPONSE PLANS

Transcription:

Eisenhower Middle School 2017-2018 Coaching Handbook Mr. Jeff Carlson, Principal Mr. Kelly Ellingson, Athletic Director 3525 Spring Creek Rd., Rockford, Illinois 61107 815-229-2450

Welcome to Eisenhower. We are excited to have you as part of our Eisenhower family. Our goal is to ensure our students/athletes develop the capabilities to learn throughout their lives, succeed in the global economy, and contribute to society. As a team we can ensure the success of our students/athletes. This handbook contains coaching information as well as student/athlete information. 2

Mission: Motto: Vision: Collaboratively engage all students in a world-class education. Shaping Tomorrow Today, transitioning from Readiness Rocks Be the first choice for all families. This vision will be achieved when the following are realities for the district: a) It is a driver of prosperity for the region. b) All students are college and career ready c) All students feel valued and empowered to reach their full potential. d) Each individual flourishes intellectually, physically, and emotionally. e) All stakeholders are both responsible and accountable for student success. District 205 believes that involvement in extracurricular activities is a significant part of a child s education and encourages all students to become involved in some capacity. Along with the privilege of being a member of an athletic team or another school activity come responsibilities. Failure to abide by established District policies and procedures results in consequences. It is imperative that both students and parents/guardians are mindful of this as they sign the acknowledgement form of the District s Code of Conduct and Sportsmanship. Required Forms for Athletic Participation: Prior to a student s participation in organized practice or competition, the following forms must be on file with all required signatures. Additional forms may be required by the individual schools. 1. Parental Permission Form 2. Student Code of Conduct Form 3. Current Sports Physical 4. Student Emergency Information Form 5. IHSA Concussion Form 6. IHSA Sportsmanship Form Participation fees, as required, must be paid in full prior to the first competition of a sport season. (An installment payment plan is available for emergency situations, and should be used at the discretion of the building athletic director). 3

COACH DUTIES/RESPONSIBILITIES Whether an individual is going to be serving as a hired coach or as a volunteer coach, it is imperative that all District Policies and Procedures are adhered to all times. Coaches will interface with the school s athletic director concerning all matters. Policies/Procedures: Will ensure that all student-athletes adhere to Academic Eligibility Policy 7.320 at all times: A. Have passed five (5) full credit courses the previous semester with a previous semester GPA of no less than 2.000. B. Be passing five (5) full credit courses on a weekly basis. C. Have no unexcused absences the previous week - including a single period. D. Ineligible students MAY practice and travel with school s team, but MAY NOT be in any type of uniform nor participate in a contest. Will follow all District Financial Procedures (consult your Athletic Director and the Athletic Handbook in the athletic office). Will ensure that students that have been placed on an out of school suspension are not on school premises at any time during the period of said suspension. Will distribute and collect all emergency information sheets to all athletes and maintain such in their possession at all practices and contests. Will ensure that all athletes have a signed Code of Conduct form on file in the athletic office. Will provide written copies to parents of all practice and game schedules. Will monitor safety conditions for athletes at all times. Will submit all required paper work to the athletic office within 24 hours (i.e. rosters, forms, contest results, and other as requested by the athletic director). Behavior: Will model appropriate behavior at all times. Will respect participants, officials, opponents, parents and all others involved at all times and will teach the student-athletes to do the same. Will promote academics as the greatest priority. Will promote fair play and uphold the spirit of the rules of the game. Will maintain communications with parents. Will perform other duties as requested by the school s athletic director or administrators. Will ensure that student-athletes are properly supervised at all times. Will promote good sportsmanship among parents, players, and officials at all times. Student Fees: All fees are to be paid prior to the first game or students/athletes are not allowed to participate. If fee is paid prior to 2 nd game students/athletes can participate. The coach will not collect any sport fees; students/athletes fee will be paid directly to the main office or Kelly Ellingson, Athletic Director.

Injury Procedures Each coach will have completed Student Emergency Information Forms in his/her possession whenever student/athletes are participating. If a school has a Certified Athletic Trainer on duty at a practice or an event, that individual will assume all responsibility for any/all injuries. Coaches will abide by the directions provided by the Certified Athletic Trainer. When a Certified Athletic Trainer is not available, the coach will assume the responsibility for handling any/all injuries. Procedures when a Certified Athletic Trainer is not in attendance: The coach will attend to the injured athlete without delay. The coach will evaluate the injury and determine if immediate medical attention is required. If so, another individual will be sent to call the local rescue until (911) while the attending coach makes the injured athlete as comfortable as possible. The coach will administer only reasonable and prudent first aid. The severity of the injury will dictate what emergency aid is required. The coach (or other) will contact the parent/guardian immediately for additional instructions. Whenever possible, that contact should be made prior to transporting an athlete. In the event an athlete must be transported, a staff member (coach) will accompany and remain with the student until a parent/guardian arrives. Coaches are NOT to administer internal medication. Coaches are required to complete a Standard Student Accident Report Form any time an injury results in the student being referred for medical services, or the student misses school as a result of an injury. These forms should be submitted to the athletic office for forwarding to the school nurse. Coaches should follow up on injuries with the parent/guardian as to the status of an injured player. If a student-athlete is referred to a physician, coaches should NOT allow participation until the student receives a written release from the physician. Emergency Response Plan for Outdoor use of AEDs Basic first aid procedures as indicated below will follow the recommendations of the Illinois Department of Human Services and the Illinois State Board of Education in their publication of First Aid Procedures for Injuries and Illnesses. Identification of the need for Cardiopulmonary Resuscitation, rescue breathing, or use of Automated External Defibrillator will follow the guidelines established by the American Heart Association, the American Red Cross, or other nationally recognized training organization. Coach or program manager staff member in charge, for activity that is conducted before or after school s business hours

DURING SCHOOL HOURS Minor Injuries or need for medical care Notify School Nurse or Principal s Office either by phone or internal calling system School Nurse, Principal, or other designated school staff will administer first aid procedures as indicated by the nature of the accident Parents will be notified by nurse, principal, or office staff, if necessary Staff witnessing the accident and/or providing first aid should complete an accident report and document on the health office log. Major Injuries or Urgent need for medical care - This is defined as any injury or medical emergency deemed by school staff as needing immediate medical care, EMS (Emergency Medical Services), or transport to a healthcare facility. Such medical emergencies may include seizures, fragile medical conditions, food or other allergic reactions in students known to have severe reactions. The first staff person identifying the emergency notifies the school nurse or Principal s Office either by phone or internal calling system. The first staff person attending to the victim provides basic first aid, CPR, if trained, and calls 911 or directs another person to call 911 immediately. If CPR or rescue breathing is required, the nurse, building administrator, or person in charge will direct a school staff member to retrieve the Automated External Defibrillator (AED). When EMS have arrived and assumed care of the patient, the nurse or building administrator will notify parent or guardian of patient s status and transport to the hospital. Staff witnessing and/or providing first aid care should complete an accident report and document on the health office log. Nurse present in the building Staff member identifies situation as emergent Uses phone or internal call button in room to notify main office of emergency Main office contacts nurse by phone or short-wave radio to bring emergency first aid bag from health office to the scene Main office contacts building administrator to retrieve AED, and bring to scene First aid/emergency care is provided as determined by need, this includes CPR or use of AED if indicated. Nurse or principal alerts main office via phone or internal calling system to contact 911 the main office personnel give EMS the school s location, age and sex of patient, suspected problem, and closest entrance to the building. The building administrator sends staff member to open door for EMS, who then directs them to the emergency. Main office provides EMS with student identifying information: name, age, sex, address, and parent contact information. When EMS has arrived and assumed care of patient, the nurse or building administrator will notify parent or guardian of patient s status and transport to the hospital. The event is documented on an accident report which is kept in the health office, signed by the building administrator, copies of which are sent to the district s office of Communications and the Superintendent 6

AFTER SCHOOL-BUSINESS HOURS Coach or program manager, which arrives first in the athletic office following school business hours, is responsible for securing the AED and taking it outdoors to the practice field. The coach or program manager signs out the unit on the sign-out sheet provided in the AED cabinet. This same coach or program manager maintains responsibility for the AED and its use until he/she turns over responsibility to another coach or program manager or until outdoor practice or athletic practice for the day is completed. The last remaining coach or program manager on site returns the AED to its cabinet and signs it back in at the conclusion of the day s athletic activity or program. In the event that an emergency situation is identified, the following process is recommended: Staff member or program manager identifies emergency situation Staff member or program manager contacts nearest volunteer or another program staff member to retrieve first aid/emergency bag and/or AED, and bring to scene. Staff member or program manager calls 911- giving EMS the school s location, age and sex of patient, suspected problem, and site of the emergency. First aid/emergency care is provided as determined by need, this includes CPR or use of AED if indicated. Staff member or program manager sends volunteer staff member to direct EMS to the emergency. Staff member, program manager or volunteer provides EMS with identifying information, if available: name, age, sex, address, parent contact information. When EMS has arrived and assumed care of patient, the staff member, program manager, or person in charge will notify parent or guardian of patient s status and transport to the hospital. The event is documented on an incident and/or accident report which are kept in the AED storage cabinet in the athletic office, signed by the staff member or program manager and a copy is sent to the district s office of Finance and Operations. If an adult refuses treatment, they are required to sign a statement stating such, as provided by the EMS ambulance personnel. 7

Heat and Humidity Guidelines The athletic training staff will evaluate practice conditions either by direct measurement on site or through weather radio. This is done before practice and as conditions warrant. Temperature and relative humidity conditions will be posted and updated for all coaches along with the following practice guidelines. Athletic trainers will keep a log record of temperature and humidity during times of extreme conditions. The following scale is used to determine what limitations are imposed on athletic activities. In game situations, IHSA officials and the administrator on duty in collaboration will make decisions regarding heat and humidity with the ATC(s) and coaches. Relative Humidity Air Temperature Practice Under 70% Under 89 No Limitations Over 70% Under 70% 80-89, or 90-99 Shortened practices with water breaks (Football - Minimum pads) Over 70% 90-99 Restricted practice as defined by coach, ATC, and administrator consultation. Any Value 100 + Suspend practice. Student athletes will be instructed to remove themselves from any athletic activity if they feel overheated. If a student athlete has any symptoms of heat related illness, he/she will be removed from any athletic activity and given reasonable and prudent immediate care by the training and/or coaching staff. The student athlete's parent/guardian will be notified and advised to contact their physician or go to the local emergency room if symptoms persist or worsen. Student athletes with any heat related illness would be reevaluated by the ATC before being allowed to return to activity. The coach will verify the student athletes practice status with the ATC prior to the athlete returning to activity. The Principal and Athletic Director will be notified of practice limitations and are responsible for monitoring the adherence to these guidelines. 8

Concussion Information Concussion Information Sheet Adapted from the CDC and the 3rd International Conference on Concussion in Sport Document created 7/1/2011 Reviewed 4/24/2013 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 the 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 may include one or more of the following: 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 9

Eisenhower Middle School Expectations OUR GOAL: To encourage student-athletes to make a strong commitment to academics and athletics. To encourage student-athletes to conduct themselves in a manner which brings respect to themselves and Eisenhower Middle School. To promote the development of self-discipline and high academic/athletic expectations. ACADEMIC STANDARDS: You are a student before an athlete Tutoring: If you are receiving one F in any of your classes you are responsible to attend athletic tutoring. (Will be available at lunchtime) Ineligible: There are three ways to become ineligible, revoking your privileges of competing. 1. Are not fulfilling your obligations of tutoring, either by not attending, or by not making good use of your time. (Need to attend 3 out of 5 days, except for last week of sport: Athlete must attend tutoring sessions leading up to final event, or will not be able to participate.) 2. Are not passing 5 classes 3. Are not passing 5 classes at the semester: this will revoke athlete s ability to compete the following semester. ATTENDANCE STANDARDS: A student-athlete must be in attendance for all class periods in order to participate in contests or practice that day. (Exceptions include medical excuse, school activities, and family emergencies) Athletic Truancy Policy: First Offense Intervention with Coach Second Offense 1 Game Suspension Third Offense 2 Game Suspension Fourth Offense Removal from athletic team BEHAVIORAL STANDARDS: Respect on and off the athletic field. In School Suspension (SILE): First Offense - 1 Game Suspension Second Offense 2 Game Suspension Third Offense Removal from athletic team If a student-athlete is sent out of a class to SILE during the school day: 0 1 Class period spent in SILE Intervention with Coach 2 4 Class periods spent in SILE Half Game Suspension 5 7 Class periods spent in SILE 1 Game Suspension Out of School Suspension (OSS): First Occurrence 1-2 days OSS 2 Game Suspension 3-4 days OSS 3 Game Suspension 5-10 days OSS Suspension from half of remaining contests Second Occurrence Removal from athletic team 10

SPORT District 205 Athletics Middle School Athletic Programs Provided FALL SCHOOLS Football (JV/V) Marshall/West, Kennedy, Flinn, Lincoln, Eisenhower, RESA Coed Soccer (JV/V) Marshall, West, Kennedy, Flinn, Lincoln, Eisenhower, RESA, Barbour Coed Cross Country (V) Marshall, West, Kennedy, Flinn, Lincoln, Eisenhower, RESA Cheer and Spirit Squads (JV/V) Marshall, West, Kennedy, Flinn, Lincoln, Eisenhower, RESA Girls Basketball (6-7-8) Marshall, West, Kennedy, Flinn, Lincoln, Eisenhower, RESA SPORT WINTER SCHOOLS Boys Basketball (6-7-8) Marshall, West, Kennedy, Flinn, Lincoln, Eisenhower, RESA Wrestling (JV/V) Marshall/West, Kennedy, Flinn, Lincoln, Eisenhower, RESA Coed Swimming (V) Marshall/West, Kennedy, Flinn, Lincoln, Eisenhower, RESA Cheer and Spirit Squads (JV/V) Marshall, West, Kennedy, Flinn, Lincoln, Eisenhower, RESA Coed Chess (V) Marshall, West, Flinn, Lincoln, Eisenhower, RESA, Barbour Girls Volleyball (6-7-8) Marshall, West, Kennedy, Flinn, Lincoln, Eisenhower, RESA, Barbour SPRING SPORT Boys Volleyball (JV,V) Coed Track & Field (V) Bowling (V) Coed Tennis (V) Coed Golf (V) SCHOOLS Marshall, West, Kennedy, Flinn, Lincoln, Eisenhower, RESA, Barbour Marshall, West, Kennedy, Flinn, Lincoln, Eisenhower, RESA, Barbour Coed Marshall, West, Flinn, Lincoln, Eisenhower, RESA, Barbour Marshall, West, Flinn, Lincoln, Eisenhower, RESA Marshall, West, Kennedy, Flinn, Lincoln, Eisenhower, RESA 11

Student Emergency Information Form Rockford Public Schools Must have required signatures to be valid. Authorization for immediate medical attention must be marked YES or a student may NOT participate. Student s name: (Last) (First) (Initial) School Grade Home Address Name of Father/Guardian Home Phone ( ) - Work Phone ( ) - Cell Phone ( ) - Name of Mother/Guardian Home Phone ( ) - Work Phone ( ) - Cell Phone ( ) - Name of responsible adult who will assume responsibility for the student-athlete if parents/guardians cannot be reached: Name Address Phone ( ) - 12

Student Emergency Information Form Continued Rockford Public Schools Physician of Choice Dentist of Choice Hospital of Choice Special health conditions of student-athlete, if any: If you and the physician of choice as indicated above cannot be reached in an emergency and, if in the judgment of the school authorities immediate medical and/or hospital attention is indicated, do you authorize school authorities to send your child (properly accompanied) to an available hospital or physician? YES NO To Parent: Please indicate in the space below any accident insurance you presently hold which covers the individual named above, such as Blue Cross Blue Shield group plans sponsored by your employer, or individual policies with an insurance company. Blue Cross (Policy Number) Group Plan (Name of Employer) Other Blue Shield (Policy Number) (Policy Number) (Policy Number) The Rockford Board of Education does not carry insurance to provide for student injuries while participating in athletics. This card must be filed in the school office before the pupil named above can participate in any athletic contest. Signature of Parent/Guardian Date 13

Sportsmanship Agreement Form All coaches, athletes and parents/guardians involved in Rockford Public School athletics and activities are expected to adhere to the Sportsmanship Guidelines provided by the Illinois High School Association and its Do What s Right campaign. This includes representing the district, school and team in a positive manner and creating a positive experience for all involved. The following is behavior expected of all coaches, athletes and parents/guardians. Represents their school and community well with positive interaction with opposing fans and players. Uses positive yells, chants, songs or gestures. Display modesty in victory and graciousness in defeat Respect and acknowledge the integrity/judgment of officials. Exhibit positive behavior with opponents and fans before, during and after the contest. More information on sportsmanship may be found at http://ihsa.org/resources/sportsmanship.aspx Athlete Agreement As a player, I understand that I must follow the above sportsmanship rules to stay in good standing with my team. Student-Athlete s Signature Date School Sport/Activity Parent/Guardian Agreement As a parent/guardian of above athlete, I agree to abide by the above sportsmanship rules, recognizing it is important to follow these conduct standards for the benefit of all involved. Parent/Guardian Signature Date 14

Parental Permission Form/Agreement School Sport/Activity Student-Athlete Name As the parent/guardian of a District 205 student choosing to participate in co-curricular activities, I agree to encourage and support my son/daughter and his/her school/activity by: Attending parent meetings as requested by the school/coach Lending support to the school s/activity s Booster Club Ensuring that my son/daughter follows all State/District/School Code of Conduct and Discipline Codes at all times Interacting with classroom teachers, counselors, and school administration on a regular basis to monitor the academic success/progress of my son/daughter Demonstrating good sportsmanship at all times: Toward coaches Toward contest officials Toward visiting and home team players Toward school personnel Submitting all fees and forms as required for participation Following the established method to address program/individual concerns by making the initial contact for a scheduled consultation at the lowest level: Assistant Coach Head Coach Site Athletic Director Assistant Principal Building Principal District Athletic Director Superintendent Attending contests in which my son/daughter will be involved as often as possible Ensuring my son/daughter has the necessary transportation to/from practices and contests As a parent/guardian, I understand that my direct involvement and support is necessary in order for this to be a valuable experience for my son/daughter. My signature below indicates that I agree to the above terms of this agreement. Parent/Guardian Name (please print) Address Cell Phone Parent/Guardian Signature Home Phone Work Phone Date 15

Concussion Information Sheet Adapted from the CDC and the 3rd International Conference on Concussion in Sport Document created 7/1/2011 Reviewed 4/24/2013 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/ Student-Athlete Name Printed Parent/Guardian Name Printed Student-Athlete Signature Parent/Guardian Signature Date 16

Eisenhower Eagles Coaching Staff This is a letter of acknowledgement regarding the Athletic programs that are being established for Eisenhower Middle School The goal is to design programs that will be modeled by other sports, schools and coaches. Each coach will be expected to follow the guidelines of the program. Only the varsity coaches/head coaches have the authority to remove a player or coach from the program after first talking with the Athletic Director. All other coaches should bring any problems to the attention of the varsity coach/head coaches so solutions can be discussed before any action is taken. All coaches are responsible for player rosters, player eligibility, uniforms, and equipment that need to be handed out or collected as well as repaired, if necessary. All coaches are expected to be on time to their practice/game. If an emergency arises, you must notify the Head Coach/Athletic Director so that arrangements can be made to cover. All coaches must supervise players until last player has been picked up or gotten on the activity bus including home and away events All coaches will only write activity bus passes for rostered players It is important to develop the fundamental skills of all players, not just some. As a coach, you need to build character and establish goals for each individual student athlete. As a coach, you will be looked at as POSITIVE role models so you must think before you react. What happens in our program stays in our program. We discuss things in private as a staff. All coaches are required to dress appropriate during games. All coaches will follow any other expectations given by Athletic Director that are not mentioned in this contract If you have any questions or concerns, please direct them to the Athletic Director, Kelly Ellingson. Team Model Dedicated To Be Educated On & Off The Field. It s All About The Student-Athlete s Success As a coach I understand that I can be released at anytime if I violate this agreement and I am aware that my pay will be adjusted if I am released or resign for any reason at all. I acknowledge and agree to follow the terms of this agreement. Coach s Signature Athletic Director s Signature 17 Date Date