Participation%20Packe%202011-12

LINCOLN HIGH SCHOOLATHLETIC DEPARTMENT2229 J Street • Lincoln, NE 68510 • (402)436-1536 Links

May 1,2011

Athletic Team Candidate:This packet includes FIVE forms, which you must complete prior to your participation in an athletic programduring the 2011-2012 school year. You and your parent(s)/guardian should read all of the written materials sothat you will understand the procedure for entering into competition and also be aware of the policies of boththe Lincoln Public Schools and the Nebraska Schools Activities Association and how they affect yourparticipation in this program.

1. Physical Examination Form (Green) -The examination must be dated after May 1st of current year.Page 1 - must be filled out completely and signed by a Physician. Page 2 - must be filled out and signedby both parent/guardian and student.

2. Parent Consent Form (Lime Green) - Read the LPS/NSAA rules and guidelines before signing. Mustbe signed by both parent/guardian and student.

3. Emergency Form (White) - Must be filled out completely and signed by parent/guardian.4. Lincoln High Student/Athlete Expectation Form (Blue) - Must be filled out completely and signed by

parent/guardian and student.5. LPS Student/Parent Letter (Goldenrod) - Read the LPS information before signing. Must be signed by

both parent/guardian and student.

You should immediately make an appointment with your doctor for your physical examination. You shouldhave your examination completed prior to the date your sport will be checking out equipment, generally oneweek before the first practice date.

Your forms must be turned in at the Lincoln High Athletic Office prior to checking out equipment and/orstarting practices. Upon receiving your completed forms, the Athletic Office will issue a "RED" ParticipationCard, which you must turn in to your coach when you check out your equipment or report for practice. TheLincoln High Athletic Office will typically be open from Sam - 4pm« Please call the LHS Athletic Office at436-1536 if you have questions.

The school year is divided into three sports seasons. 1. The Fall Sports season's first day of practice will beMonday, August 8 for Football, Girls Golf and Softball and Monday, August 15 for Boys and Girls CrossCountry, Boys Tennis and Girls Volleyball. 2. The first day of practice for the Winter Sports season will beMonday, November 14. The programs offered are Boys and Girls Basketball, Boys and Girls Swimming, andWrestling. 3. The Spring Sports season will begin on Monday, February 27 for Baseball, Boys Golf, Boys andGirls Soccer, Girls Tennis, and Boys and Girls Track.

Good luck in your participation in the Lincoln High School programs.

Pat GatzemeyerAthletic Director

PHYSICAL EXAMINATION REQUIREMENTSHealth Services Department

Lincoln Public Schools"The Board of Education shall require evidence of a physical examination by a physician, physician assistant, or an advanced practice registered nurse within six months prior to the entrance of a child into the beginner grade and the seventh grade, or in the case of a transfer from out-of-state to any other grade of the local school; provided no such examination shall be required of any child whose parent or guardian shall object thereto in writing." A complete visual evaluation is required at the entry grade (kindergarten, or grade of transfer from out of state). A vision professional may also complete the required visual evaluation. Waiver forms are available in each school health office. School Law 79-214 (3). Physical examinations are recommended at the third and tenth grade in addition to the required examinations. Annual Blood Pressure, Hemoglobin/Hematocrit and Blood Lead Level are required for ExCite (Head Start) preschool students.

Each student participating in interscholastic athletics is required to have a complete physical examination (Nebraska School Activities Association requirement) to be given after May 1 of each year. This certifies that the athlete is qualified for the entire school year, May 1 through the following closing day of school, or the current school year.

For participation in interscholastic athletics, please complete other side.

Name School Grade

Address Zip Age Sex: M F

Physician

PHYSICAL FINDINGSHeight WeightBlood Pressure PulseUrinalysisHemoglobin/Hct

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Immunizations given during today's visit:

DTP ____ Td ____ polio ____ MMR _____ Hib ____ Hep B____

Varicella _____ other (list) ________________________________ (Please attach copy of immunization record on file.)

Significant findings/Chronic Health Problems (please review health history)

Required medication on a daily or episodic routine

Please check classificationq Regular: Student may participate in the regular program of physical education, recreation, intramurals, athletics or related activities without undue

risk or injury.q Adapted: Student has a condition which might risk sustaining injury from participation in the regular program or needs a special adapted program

as indicated by the consulting physician. Reexamine each year.q Exempt: Student has a severe handicap which might risk sustaining injury from participation in the regular or adapted programs. These students

should be re-examined for possible reclassification at the end of the exemption period.Please check certificationq Certified: Student has passed the physical examination successfully and is physically able to participate in interscholastic athletics. Activities student should not participate inRecommendations: Your signature below indicates completion of physical exam and review of health history.

Date Signed , M.D. Examining Physician (Signature Required)

Clinic/Practice Name (please print)

Physician Address Physician Phone

Return to School Health Office

MEDICAL Normal Abnormal FindingsAppearanceEyes/ears/nose/throatLymph nodesHeart (note murmur if presentPulses (inc. Femoral)LungsAbdomenSkinMUSCULOSkELETAL Neck SpineShoulder/armWrist/handElbow/forearmHip/thighKneeLeg/ankleFootEvidence of Scoliosis no yes

Evidence of Hernia no yes

Stigmata of Marfan's Syndrome no yes

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Audiometric Screening Report, if given

PASS FAIL RECOMMEND FURTHER EvALUATION (see comments below)Amblyopia ___________ __________ __________Strabismus ___________ __________ __________Internal Eye Health ___________ __________ __________ External Eye Health ___________ __________ __________Visual Acuity ___________ __________ __________ 20 feet: Right 20/ ___ Left 20/ ___ with/without glasses 16 inches: Right 20/ ___ Left 20/ ___ with/without glasses

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The Lincoln Public Schools' Medical Advisory Committee recommends that every student participating in interscholastic athletics complete a medical questionnaire to reduce the risk of serious injury in young athletes. In addition to physical examination by a qualified health professional, completion of the following questions will aid the identification of any health concerns related to athletic participation.

Parent or Guardian: Please complete and sign below if your child is interested in interscholastic sports participation.

Student School Grade

Address Zip Age Sex: M F

Sport(s)

Circle questions you don't know the answers to. Explain "Yes" answers below.

PHYSICAL EXAMINATION REQUIREMENTS(Preparticipation Medical History)

Health Services DepartmentLincoln Public Schools

Y N1. Has there been a medical illness or injury since the last checkup or

sports physical? q q

2. Has the student ever been hospitalized overnight? q q Has the student ever had surgery? q q

3. Is the student currently taking any prescription or nonprescription (over-the-counter) medications or pills or using an inhaler? q q Any supplements or vitamins to help weight gain/weight loss or improve athletic performance? q q

4. Does the student have any allergies (for example, to pollen, medicine, food or stinging insects)? q q Has the student ever had a rash or hives develop during or after exercise? q q

5. Has the student ever passed out during or after exercise? q q Has the student ever been dizzy during or after exercise? q q Has the student ever had chest pain during or after exercise? q q Does the student get tired more quickly than friends do during exercise? q q Has the student ever had racing of their heart or skipped heartbeats? q q Has the student ever had high blood pressure or cholesterol? q q Has the student ever been told he/she has a heart murmur? q q Has any family member or relative died of heart problems or of sudden death before age 50? q q Has any family member or relative been diagnosed with cardiomyopathy (thick heart), long QT Syndrome or Marfan Syndrome? q q Has the student had a severe viral infection (for example myocarditis or mononucleosis) within the past month? q q Has a physician ever denied or restricted participation in sports for any heart problems? q q

6. Does the student have any current skin problems (for example, itching, rashes, acne, warts, fungus or blisters)? q q

7. Has the student ever had a head injury or concussion? q q Has the student ever been knocked out, become unconscious or lost their memory? q q Has the student ever had a seizure? q q Does the student have frequent or severe headaches? q q Does the student ever have numbness or tingling in arms, hands, legs or feet? q q Has the student ever had a stinger, burner or pinched nerve? q q

Y N8. Has the student ever become ill from exercising in the heat? q q

9. Does the student cough, wheeze or have trouble breathing during or after activity? q q Does the student have asthma? q q Does the student have season allergies that require medical treatment? q q

10. Does the student use any special protective or corrective equipment or devices that aren't usually used for their sport or position (for example, knee brace, special neck roll, foot orthotics, retainer on their teeth or hearing aid)? q q

11. Has the student had any problems with their eyes or vision? q q

12. Has the student ever had a sprain, strain or swelling after injury? q q Has the student broken or fractured any bones or dislocated any joints? q q Has the student had any other problems with pain or swelling in muscles, tendons, bones or joints? (Check which apply.) q q q Head q Elbow q Thighq Neck q Forearm q Kneeq Back q Wrist q Shin/Calfq Chest q Hand q Ankleq Shoulder q Finger q Footq Upper arm q Hip

If yes, check appropriate box and explain below. 13. Does the student want to weigh more or less than at present? q q

Does the student lose weight regularly to meet weight requirements for sport? q q

14. Does the student complain of feeling stressed out? q q

Females ONlY15. When was the first menstrual period? ___________________________ When was the most recent menstrual period? _____________________ How much time usually passes between

the start of one period and the start of the next? ___________________ How many periods have the female student had in the past year? _____ What was the longest time between periods in the past year? _________

I hereby state that, to the best of my knowledge, my answers to the above questions are complete and correct. The information provided here may be shared with other school personnel as needed to promote your child's safety and educational success at school.

Signature of athlete _________________________________________ Signature of parent/guardian ________________________________ Date ____________________

HS0020page 2 of 2

explain Yes answers Here: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

PARENTS’ CONSENT RECORDFOR PARTICIPATION IN ACTIVITIES

Department of Athletics and Student Activities Lincoln Public Schools

The activities program of the Lincoln Public Schools is considered an integral part of the total educational program. Pupils participate of their own accord and with parents' knowledge and consent.

THESE ARE LINCOLN PUBLIC SCHOOLS MINIMUM STANDARDS. INDIVIDUAL HIGH SCHOOL REQUIREMENTS MAY VARY. PLEASE CHECK WITH THE SCHOOL YOU WILL BE ATTENDING FOR THEIR REQUIREMENTS.

Lincoln Public Schools RulesExpectations, rules and regulations of student conduct and behavior (Extracurricular Activities Code of Conduct ) are listed in the Im-portant Information Handbook distributed to parents at the beginning of each school year. In addition they can be accessed through the LPS Website <lps.org> under “Popular Pages” and also in the LPS Policy Manual, Policy # 6740 (also found under Popular Pages on the LPS website). A copy of the Extracurricular Activities Code of Conduct may also be obtained upon request in the office of the Director of Athletics or from the High School Associate Principal in charge of Activities.

Parents and students are expected to become familiar with the entire Code of Conduct. Inappropriate conduct, as defined in these documents, shall constitute grounds for suspension from practices, participation in interscholastic competition or other participation in extracurricular activities.

Failure to report for the activity at the beginning of each season could result in the student’s exclusion from that activity; reporting for one activity may count as reporting on time if there is a change in activity within the season as approved by the sponsor or coach.

Students participating in interscholastic athletics are required to have a physical examination once each year, completed after May 1 of the current school year, which certifies the athlete is physically able to participate in interscholastic athletics. In accordance with LPS Form 526009 (Physical Examination Requirements) Lincoln Public Schools does not accept a physical examination completed by a chiropractor.

All students who participate in a credit bearing regular class or in student activities/athletics for which the district extra standard service stipend is provided to teachers/sponsors/coaches are: a) required to have on the school records credit for twenty hours of school work for the immediate preceding semester to participate and b) must be taking twenty credit hours of instruction per week from the Lincoln Public Schools during the semester of participation. Students enrolled in schools with modular scheduling are required to be enrolled in a minimum of 15 credit hours per quarter and must also pass a total of 20 credit hours the previous semester. In the case of unusual circumstances, the participant, guardian or representative may discuss the matter with the appropriate school personnel and seek a waiver from this regulation for activities not under the rules and regulations of the Nebraska Schools Activities Association. In the case of an alleged infraction of the Code of Conduct, the participant may be suspended from practice, participation in extracur-ricular activities of a selected class or interscholastic competition. In any case the procedures for suspension, (regulation 6740.1) will be followed. The Code of Conduct as printed in the Important Information Handbook lists MINIMUM standards. Individual High School requirements may vary. Please check with the school where you will be attending for their requirements.These rules are supplemental to Lincoln Public Schools policies 5480, 6720 and 6721 and any action taken hereunder may be in addition to any action taken under these policies.

Due Process for Extracurricular ActivitiesStudents may be suspended by the principal or his/her designee from practices or participation in interscholastic competition or par-ticipation in co-curricular activities for violation of rules and standards of behavior adopted by the Lincoln Board of Education or the administrative staff of the school.

If a participant, the student's parents or guardian are not satisfied with the determination by the activity sponsor or coach, a hearing may be requested. However, the student will remain suspended from the activity pending the outcome of the hearing.

Procedures which will be followed with regard to suspension are contained in Lincoln Public Schools Policy and Regulation manual; Regulation 6740.1. A copy of this regulation may be obtained by contacting the Lincoln Public Schools activity office.

Additional procedures for due process for long- term suspension, expulsion or mandatory reassignment are found in Lincoln Public Schools Policy and Regulation manual; Regulation 5481.

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Student Application for ParticipationThis application to participate in interscholastic activities for the Lincoln Public Schools is entirely voluntary on my part and is made with the understanding that I have read the eligibility rules and regulations of the Nebraska School Activities Association and the rules and regulations of the Lincoln Public Schools and I am not in violation of such rules.

Date Student

Parent's or Guardian's Consent

I hereby give my consent for to participate (Student's Name)

for School in activities approved by the (Name of School)

Lincoln Public Schools.

I/we realize that participation involves the potential for injury which is inherent in all sports. I/we acknowledge that even with the best coaching, use of the most advanced protective equipment and strict observance of rules, injuries are still a possibility. On rare occasions these injuries can be so severe as to result in total disability, paralysis, or even death.I/we acknowledge that I/we have read and understand this warning.I/we have read the rules of eligibility pertaining to activities participation and acknowledge and understand the purpose and content thereof, including the parent domicile, student transfer and eligibility crediting rules.I/we acknowledge that parents are obligated to pay for professional medical and/or related services; the school shall not be liable for payment of such services.I/we acknowledge that parents are obligated to pay for professional medical and/or related services; the school shall not be liable for payment for such services. The signing student and the undersigned Parent/Guardian gives permission to any and all of the stu-dent’s health care providers to release and discuss all records and information such health care providers may have about the student (including otherwise confidential medical information and records) to Lincoln Public Schools and its employees, staff, agents, and consultants. The signing student and the undersigned Parent/Guardian further gives permission to Lincoln Public Schools, its employees, staff, agents, and consultants, to release and discuss all records and information it has (including other-wise confidential medical information or records) to the students health care providers. I understand that this release has been requested and may be used for the purpose of determining eligibility pertaining to activities participation, fitness, injury, injury status, or emergency.I/we acknowledge that insurance coverage is recommended for all participants at parents' expense, and insurance information is available in the Athletic Director's office and/or in the main office of the school.I/we acknowledge that all activity participants are required to have on school records a minimum of 20 hours credit for the immediate preceding semester, must currently be taking 20 credit hours of instruction each week and that some Lincoln High Schools requirements are greater than this minimum. We also acknowledge students enrolled in schools with modular scheduling are required to be enrolled in a minimum of 15 credit hours per quarter and must also pass a total of 20 credit hours the previous semester.I/we understand the activity may be conducted at a location other than the student's school of attendance. The school and district will not provide transportation between the school of attendance and the site of the extra-curricular activity.I/we also understand transportation to the site is the responsibility of the student and/or parent/guardian, and may involve transportation by a private vehicle driven by others.I/we understand good sportsmanship is essential to the success of any athletic program. It is also understood that inappropriate behavior at any Lincoln Public Schools contest may result in removal from the contest and may result in suspension from attending future con-tests.I/we give our permission for academic information including grade point average, class rank and any academic awards/recognition re-ceived by the student/athlete to be released for the purpose of recognizing excellence in both athletics and academics. Most typically this information will be used by newspapers, school publications and for awards banquets or assemblies, all-conference or all-state awards.I/we understand and agree that participation in NSAA sponsored Activities is voluntary on the part of the student and is a privilege.I/we consent and agree to our student being photographed, video taped, audio taped, or recorded by any other means while participating in NSAA activities and contests, consent to and waive any privacy rights with regard to the display of such recordings, and waive any claims of ownership or other rights with regard to such photographs or recordings or to the broadcast, sale or display of such photographs or recordings.

Date Signature of Parent/Guardian

(Student Signature)

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Nebraska School Activities Association RulesIn order to represent a Nebraska high school in interscholastic competition, a student must abide by eligibility rules of the Nebraska School Activities Association. A sum-mary of the major rules is given below. Contact the principal or activities director for an explanation of the complete rule.If you do not understand a summary of these rules listed below or you need an explanation of other requirements, consult the high school principal or athletic director. • Student must be an undergraduate. • After a student's initial enrollment in grade nine, he/she shall be ineligible after eight semesters of school membership beginning with his/her enrollment in grade

nine. • Student is ineligible if 19 years of age before August 1 of the current school year. (Students in grades 7 or 8 may participate on a high school team if he/she was 15

years of age prior to August 1 of current school year.) • Student must be enrolled in some high school on or before the 11th day of the current semester. • Student must be enrolled in at least 20 hours per week and regular in attendance, in accordance with the school’s attendance policy at the school he/she wishes to

represent in interscholastic competition. • Student must have been enrolled and received 20 semester hours of school the immediate preceding semester. • Guardianship does not fulfill the definition of a parent. If a guardian has been appointed for a student, the student is eligible in the school district where his/her

natural parent(s) have their domicile. Individual situations involving guardianship may be submitted to the Board of Control for their review and a ruling. • A student entering grade nine for the first time after being promoted from grade eight of a two-year junior high, or a three-year middle school, or entering a high

school for the first time after being promoted to grade ten from a three-year junior high school is eligible. After a student makes an initial choice of high schools, any subsequent transfer, unless there has been a change of domicile by his/her parents, shall render the student ineligible for ninety school days.

If a student has participated on a high school team at any level as a seventh, eighth, or ninth grade student, he/she has established his/her eligibility at the high school where he/she participated. If the student elects to attend another high school upon entering ninth or tenth grade, he/she shall be ineligible for ninety school days.

Student eligibility related to domicile can be attained in the following manners: • If the change in domicile by the parents occurs during a school year, the student may remain at the school he/she is attending and be eligible until the end of the

school year or transfer to a high school located in the school district where the parents established their domicile and be eligible. • If the parents moved during the summer months and the student is in grade twelve, the student may remain at the high school he/she has been attending and retain

eligibility. • If a student has been attending the same high school since initial enrollment in grade nine, he/she may retain at that high school and retain eligibility, or he/she is

eligible at a high school located in the school district where his/her parents established their domicile. • If the parents of a student change their domicile from one school district that has a high school to another school district that has a high school, the student shall be

eligible immediately in the school district where the parents established their domicile. • Transfer students who have their Enrollment Option applications signed and filed prior to March 15 shall be eligible immediately in the fall. Those students who

do not have their Enrollment Option applications signed and filed prior to March 15 shall be ineligible for ninety school days, with such transfers being subject to hardship waiver guidelines.

• Other non-enrollment option transfer students must have signed and delivered all forms necessary to make such transfer to the school in which he/she intends to enroll for the next school year prior to March 15; for the student to be eligible, the school to which the transfer is being made must have notified the NSAA office in writing, postmarked not later than March 15. Those students who did not have their enrollment forms signed, delivered and accepted prior to March 15, shall be ineligible for ninety school days, with such transfers being subject to hardship waiver guidelines.

• Once the transfer papers have been signed, filed and the NSAA has been notified, the student could complete that year of eligibility in the school the student was leav-ing. The student would, however, become ineligible for ninety (90) school days the next fall if the student were to change his/her mind and decided not to transfer.

• Once the season of a sport begins, a student shall participate in practices and compete only in athletic contests/meets in that sport, which are scheduled by his/her school. Any other competition will render the student ineligible for a portion of, or all of, the season in that sport. The season of a sport begins with the first date of practice as permitted by NSAA rules.

• During the season of a particular sport, athletes participating in that sport for a high school may attend, but may not physically take part, either as an individual or as a member of a team, in the sport activity in which instruction is being offered in the clinic, camp or school.

• A student shall not participate on an all-star team while a high school undergraduate. • A student must maintain his/her amateur status. • A student shall not participate in a contest under an assumed name.

Eligibility DeterminationsThe Director of Athletics/Student Activities or his/her designate, hereinafter the "Director," shall act as the member school and the Superintendent's designate and shall conduct the initial investigation and shall make the initial determination and declaration of eligibility or ineligibility for students to represent a member school in inter-scholastic competition in those activities which are under the jurisdiction of the Nebraska School Activities Association, hereinafter "NSAA." Any questions, problems, or issues by building level athletic directors, coaches, or sponsors regarding a student's eligibility shall be referred to the Director for initial determination. After initial investigation, the Director shall issue an initial written determination of eligibility or ineligibility. If the initial determination is that the student is ineligible, the director shall issue a notice of ineligibility. If, within five (5) days, after the initial determination, the Director receives a written request from such student, the member school shall sponsor an appeal on behalf of the student declared ineligible to the Executive Director of the NSAA for a hardship waiver in accordance with NSAA procedure. If the decision of the Executive Director of the NSAA is unfavorable to the student, the member school shall continue to sponsor an appeal on behalf of the student to the Board of Control in accordance with NSAA procedure.

Athletic Information If the student, parents, coach, or athletic trainer feel that the student is not in good physical condition, participation will not be permitted. The school principal and/or athletic director will be notified of the student's physical condition if there is a question regarding participation.In case of injury received either in practice or in a game, the Board of Education will endeavor to furnish temporary first aid only. The school cannot perform or be held responsible for any medical attention which might be required, nor can it assume or be liable for loss or damage suffered by reason of injuries to pupils. If, in case of injury, the parent or the family physician cannot be located, the staff is authorized to use their best judgment in obtaining competent medical care and service. Parents are obligated to pay for professional medical and/or related services; the school shall not be liable for the payment of such services.Insurance coverage is recommended for all participants at parents' expense. Parents are urged to purchase the accident coverage they prefer. The Board of Edu-cation and the Nebraska School Activities Association require each student who participates in any phase of the athletic program to have an annual physical examination to be given after May 1 of each year. This certifies that the athlete is qualified for the entire school year: June 1 through the following school year. Physical Examination reports, Parents' Consent Record and Emergency Information report forms MUST all be completed and returned to the school athletic director.CautionParticipation in these activities involves the potential for injury which is inherent in all sports. Even with the best coaching, use of the most advanced protective equipment and strict observance of rules, injuries are still a possibility. On rare occasions these injuries can be so severe as to result in total disability, paralysis, or even death.

A Statement on Transportation Relating to Student ActivitiesIt is important that parents be aware of the types of transportation which may be used in connection with the athletics program of the Lincoln Public Schools. 1. Senior high students are transported from the school to participate in other cities and returned to the school after the event. 2. Students may be expected to find their own transportation to and from the event in town. 3. Students that are transported to events are to travel to and from the events on school provided transportation. Parents or guardians may submit advance written request

to have a parent personally pick up their student only.

Lincoln Public SchoolsStudent Information

TO BE COMPLETED BY PARENT/GUARDIAN

Student Number

Student Last Name First Name MI

Date of Birth Age as of Aug. 1 Grade Male Female

Month Day Year

Please give the year student first entered the ninth grade:

School Attended Previous Semester

Residing With:Father's Mother's Parents'First Name First Name Last Name

Address City State

Zip Code Home Phone Emergency Phone

Cell Phone Email

Please check if we may share your email address with Booster Groups.

STUDENT ELIGIBILITY STATUSPlease place a in front of the statement which correctly identifies the student's status in regard to his/her residence:

Living with both natural parents.

Living with parent(s), this parent(s) has legal custody.

Living with one natural parent, this parent does not have legal custody.

Living with legal guardian.

None of the above residence conditions apply.

Not Residing With:Please list any other parents (NOT LISTED ABOVE) with whom you DO NOT reside.

Father's First Name Last Name

Address

Mother's First Name Last Name

Address OVER

(Student/Parent Signature required on next page)

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Please Print Lincoln Public SchoolsEMERGENCY INFORMATION REPORT

Lincoln, NebraskaStudent ID #

Name Address Zip.

Date of Birth / / Q Male O Female Grade Student Cell #

Activities in which you intend to participate: Fall Winter SpringAthletics: CC FB GO SB TEN VB BB SW WR BASE GO SOC TEN TR

Band Choir Speech Debate Drama Dance Cheerleading DECA FBLA Skills USAHOSA FCCLA Orchestra Science Olympiad Vocal Music Symphony Other

Father/Guardian

Home Address Phone

Business Address Phone

Email Address Cell Phone

Mother/Guardian

Home Address Phone

Business Address __ Phone

Email Address Cell Phone

Name of person other than the above to contact _

Relationship Address Phone

Cell Phone •

Family Physician Address Phone

Health Insurance Yes No Company Policy Number

Do you regularly take any medications? If yes, which ones?

List any allergies or special conditions you may have

Do you wear glasses or contacts? If yes, which?.

Record of Illness (check those that have occurred)Q Appendicitis Q Skin Disease Q AsthmaQ Hernia D Diabetes Q History of SeizuresQ Rheumatic Fever Q Kidney Disease Q Allergy AnaphlaxisQ Bone and Joint Disease Q Other To:

Record any serious injuries or operations.

The Activity Sponsor, Athletic Trainer, Team Physician, and/or Coach will apply first aid treatment until the family doctorcan be contacted.We give our permission for these individuals to use their own judgment in securing medical aid and ambulance service incase the parents/guardian cannot be reached.

Parent/Guardian Signature Date

LINCOLN HIGH SCHOOL STUDENT-ATHLETE EXPECTATIONS

I. PHILOSOPHICAL BELIEFS: The purpose of this policy is:

A. To encourage student/athletes to make a strong commitment to academics and athletics; B. To encourage student/athletes to conduct themselves in a manner which brings credit to

themselves and Lincoln High School; C. To promote the development of self-discipline and high academic/athletic expectations; D. To encourage student/athletes to stay “on line” for graduation.

II. ACADEMIC STANDARDS: The following standards must be met in order for a student to remain

eligible for athletic competition: A. Maintain enrollment in a minimum

B. Must have passed a minimum of 25 credit hours the preceding semester. Waivers of this rule may be allowed for lower level competition with an athletic director approved contract.

of 30 credit hours per semester (semester of competition and preceding semester).

C. During the course of a student/athlete’s competitive season, grades will be checked on a weekly basis. Any F/U/I may result in probation or suspension from competition for the following week. A suspension may continue as long as the F/U/I stands. Any student with an F/U, or any student assigned by the athletic office will be required to show positive academic progress.

D. A student withdrawing from a class with a grade of “WF” will not be penalized, if they maintain 30 hours during that semester. Seniors

may take a minimum of 20 hours with the approval of the athletic director. Athletes must submit a transcript with verification, from a counselor, that they are on line to graduate taking less than 30 hours. A current class schedule must also be submitted with this request.

III. ATTENDANCE STANDARDS: Will coincide with the Lincoln High School attendance policy. A. Truancies: (one truancy equals one class period)

1 Truancy Intervention – coach 2 Truancies 1 contest suspension 3 Truancies 2 contest suspension 4 Truancies Suspension for remainder of season

B. A student must be in attendance for ALL

class periods in order to participate in contests or practice that day. (Exceptions are medical appointments, school business/activities, or prearranged absences, as approved by Lincoln High School).

IV. CITIZENSHIP STANDARDS: A. A student may not participate in practices or contests while serving an out-of-school suspension.

In-School suspensions will be evaluated individually by the athletic director to determine practice or contest participation.

B. Students may not possess, or consume alcohol, drugs, or tobacco during the season, or at any school function. Consequences for violations are as follows: 1. First Offense

a. Exclusion, for 15 days (excluding Sundays), from attendance at all school athletic events. If the violation should occur at the conclusion of one sports season, it shall commence, or carry over to the start of the next season of participation;

:

b. The student may be required to attend all team practices, as determined by the head coach and athletic director;

c. Automatic SCIP referral for use of alcohol or drugs.

2. Exclusion from athletic participation for the remainder of the current school year.

Second Offense

3. Exclusion from further athletic participation while enrolled at Lincoln High School.

Third Offense

C. Theft, vandalism, illegal and/or unethical behavior (in school/out of school) is unacceptable. Upon evidence of such behavior, the student will be removed from the sport and will be subject to review by the Athletic Director for appropriate action.

D. Athletes will be required to follow additional rules and guidelines established by the coach of his/her squad, as approved by the athletic director. Violations of these rules will be handled at the discretion of the coach. In the case of repeated minor violations, insubordination, or severe violations, the student may be suspended from participation, or removed from the squad.

IMPORTANT: All rules dealing with Citizenship Standards (part IV), are accumulative, which means that a violation during a student’s first year as a member of a LHS athletic program, will count as that student’s first violation during the remaining years of enrollment at Lincoln High. **Citizenship rules apply to student conduct during the entire school year. This period begins with the first day of fall sports practices and ends with the last day of classes/finals, inclusive.

V. ELIGIBILITY TO PARTICIPATE, TEAM SELECTION AND PLAYING TIME: "Eligibility to participate," "Team selection" and "playing time" decisions are the responsibility of the individual coach. Consistent, however, with the purposes of the athletic program, the coaches shall follow the following established guidelines for eligibility, team selection and playing time decisions, along with such other guidelines as each individual coach and sponsor may develop which are not inconsistent with these established guidelines: A. School Representative

B. Success. Student participants must demonstrate that they can make the activity/program more successful, both from a standpoint of competitive success and success in promoting a positive school spirit. Characteristics for purposes of this criteria include the student's: (1) talent or skill, (2) desire to improve the student's own skills or talents as well as those of others in the activity, (3) attitude of respect towards teammates, the coach, the school, and the community, and (4) demonstrated good citizenship in the school and in the community.

. Student participants must demonstrate that they have, can and will represent themselves and their school in a manner which reflects the development of high ideals and appropriate values, which shall include good citizenship in the school and in the community.

Student’s Name _______________________________________________ Please Print ____________________________________ _______________________ (Student’s Signature) (Date) ____________________________________ _______________________ (Parent/Guardian Signature) (Date) Updated: 5/1/10

Dear Parent/Guardian and Student Athlete:

Over the past few years it has come to our attention some parents and students have some serious misconceptions regarding the high school competitive athletic program. Please take a few moments to read this letter. Hopefully, this will help you understand how a competitive program is conducted and what comprises our expectations and philosophy.

1. In each program, a coach and/or coaches are hired by the school district to be responsible for team selection. Selection criteria are established by the head coach; sometimes with input from the entire coaching staff. This may be a highly subjective process. Team selection, practices, and decisions regarding game situations are the responsibility of the coaching staff. If you have questions regarding the process, please feel free to address these questions directly to the head coach. Please call the coach to make an appointment outside of school, practice or game time. If you have further questions the coach has not been able to answer, please contact the athletic director.

2. The Lincoln Public Schools athletic program has become highly competitive. Due to large schools and limited opportunities we are not able to place every child on a team who wishes to participate. While this is not our desire, it is reality. The hardest thing our coaches have to do is to tell young people they will not be on a team. Please be sure when your child tries out for a team, both you and they understand there is every real possibility they may not be selected. If selected, both you and your child should be prepared to accept placement at any team level (i.e. 9th grade, reserve, junior varsity or varsity). It is disturbing to have a student tryout for a team and then quit because they were not placed where "they think" they should be. By doing this, they have taken away someone else's opportunity to be on a team. Normally, coaches have a very short amount of time to make team selections. They try to do the very best they can in keeping the most talented athletes, filling positions for play, and appropriately placing them on the proper team. They are under a good deal of pressure to assemble the most competitive team possible. Anyone of us might select different athletes for the team. We believe it is the coaches' responsibility and right to select the team with whom they will work for the entire season.

3. Our experience in athletics reveals there are many "select teams" sponsored by many different organizations. Each coach looks for something different in his or her players. Participation on a "select team" does not guarantee any player a spot on another "select team" or any high school team. While we believe players can gain valuable experience outside of the school athletic program, neither parents nor students should count on this type of participation to "guarantee" a spot on a high school team.

OVER

4. In order to make a varsity team as a senior, a player must be outstanding and also play a position the team needs. Under class persons possessing these qualities have the same opportunity to make a team as the senior does. Our team structure (9th, Reserve, Junior Varsity, Varsity) dictates there will always be more under class players than upper class in the total program. At selection time, it will be the coaches' decision. Students selected for a team may participate at their grade level or above, but they are not allowed to play on a lower level team. For example a ninth grader maybe selected to play on any team: 9 th , Reserve, JV or Varsity. 10 th graders may participate on reserve, JV or Varsity, 11 th graders on JV or Varsity and a senior will only be allowed to participate at the varsity level.

5. A main goal of a competitive athletic program is to put the most talented members of the team in competition to win the contest. Starting positions and playing time are not guaranteed to seniors making a team, or anyone else for that matter. Each member of a team is very valuable to the team's overall progress. Some members may play a great deal of time in a contest while others may not see what a parent would consider to be "significant" playing time. Personal improvement should be one of the goals of each student. By being a member of a team, regardless of time spent in actual competition, a person can learn many valuable lessons. Among them are the following: citizenship, sportsmanship, appreciating good play by an opponent, working together to meet team goals, responsibility and commitment to team and school, loyalty, placing team above self, learning to accept instruction and criticism, respect for others, winning and losing with dignity, self­control, and being responsible for one's own actions.

We sincerely hope this helps you to understand the goals and philosophies of the competitive athletic program in the Lincoln Public Schools. Please feel free to contact us if you have any questions regarding any aspect of the athletic program.

Lincoln Public Schools Athletic Department Offices

LINCOLN HIGH LINCOLN EAST LINCOLN NORTHEAST 436­1536 436­1313 436­1337

LINCOLN NORTH STAR LINCOLN SOUTHEAST LINCOLN SOUTHWEST 436­1305 436­1359 436­1306

DISTRICT ATHLETIC OFFICE 436­1811

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Lincoln Public Schools Department of Athletics

Lincoln, Nebraska Attachment to Student/Parent letter regarding the processes in selecting, assigning team members and athletic department goals.

Please detach and return this signed form when trying out for a team.

I/we acknowledge that I/we have read and understand the attached letter.

Student Athlete _______________________________________ (please print name)

School _______________________ Date _________________

Signature of Parent/Guardian ____________________________

Signature of Student Athlete ____________________________