Walter J Baird Sports/Activities 2020-2021 …...2018/02/20  · PARENTAL/PERSONAL CHEERLEADER CONTRACT WALTER J. BAIRD CHEERLEADING 20 20-2021 PARENTAL PERMISSION Our son/daughter,

PARENTAL PERMISSION TO PARTICIPATE Walter J Baird

Sports/Activities 2020-2021

Name:_________________________________ School_______________________ Grade_____ Sport/Club___Cheerleading_________________ Date of Birth___________________________ Home Phone_____________________________ Work Phone____________________________ Cell Phone_____________________________________________________________________ Home Address__________________________________________________________________ ______________________________________________________________________________ Email Address__________________________________________________________________ Health Insurance Company________________________________________________________ Health Policy Number____________________________________________________________

Authorization to Participate I, THE PARENT OR LEGAL GUARDIAN OF THE CHILD LISTED ABOVE ON THIS FORM, GIVE CONSENT AND PERMISSION FOR THE ABOVE LISTED CHILD TO PARTICIPATE WITH THE WALTER J BAIRD MIDDLE SCHOOL SPORTS/ACTIVITIES PROGRAM. I UNDERSTAND THAT MY CHILD MUST HAVE A PHYSICAL ON AN APPROVED FORM DATED BEFORE TRYOUTS OR LATER AND MUST PROVIDE PROOF OF INSURANCE BEFORE THEY WILL BE ALLOWED TO PARTICIPATE IN THE SPORTS/ACTIVITIES PROGRAM. (THIS INCLUDES ANY TRYOUTS OR PRACTICE).

Authorization for Transportation As the parent or guardians of ___________________________________________________, I give my permission for him/her to be transported by parents or guardians who are approved by Lebanon Special School District to transport students to school events including but not limited to athletic, club and extracurricular events.

Media Release: (PLEASE INITIAL) _____ I give my permission to Walter J Baird Middle School, the WJBMS Cheerleading Squad, and the Advisors to allow photographs, video, audio, and interviews by the media of my child. I do further certify that I am of full legal capacity to execute the above authorization and release.

Student Signature_______________________________________________Date____________

Parent/Guardian Signature________________________________________Date____________

Required Forms before allowed to participate in tryouts Parental Permission to Participate _______ Parental/Personal Cheerleader Contract _______ Extracurricular Permission/Medical Consent _____ Concussion Form _______ Cardiac Arrest Form _______ Physical _______ Proof of Health Insurance _______ (Must have a copy of Insurance Card or email a picture to [email protected])

PARENTAL/PERSONAL CHEERLEADER CONTRACT

WALTER J. BAIRD CHEERLEADING 2020-2021

PARENTAL PERMISSION

Our son/daughter, _______________________________, has our permission to tryout for the

cheerleading team at Walter J. Baird Middle School for the 2020/2021 season. If chosen, he/she has our

permission to participate as a member of the cheerleading team for the cheer season of 2020-2021. I understand

that my role as a supportive cheer parent is vital to the success of the WJB Cheerleading program and my child

as an athlete. I will assist in every way to see that the rules and regulations are enforced.

I will do my best to support the coaches and administration in decisions made throughout the cheer

season. I understand that the school and coaches assume no responsibility for any accidents and injury that might

occur either at school, practice, competitions, an event, a fundraiser, a game, or away from school grounds at any

time. Of course, every attempt will be made to properly supervise all activities to prevent any accidents or

injuries.

I understand that each cheerleader will be required to have a physical exam form dated by the first

cheerleading practice, Parental Permission to Participate, Parental/Personal Cheerleader Contract, Heads Up

Concussion in Youth Sports, Cardiac Arrest, Medical Consent, and a copy of the cheerleader’s health insurance

card on file in the office prior to practice for tryouts. These forms may be found in the office attached to the

cheerleading tryout packet and through the WJB website under cheerleading. I understand that vacations must be

scheduled as not to conflict with any scheduled games, practices, appearances, and camp; all are mandatory for

the sport. I understand the cost, time commitment, demerit system, and travel time involved with the sport of

cheerleading. I also agree to the terms that judgments and placements of the squad by the judges and coaches are

final. I do hereby give my consent and support for my son/daughter to tryout and, if selected, to be a cheerleader

at Walter J. Baird Middle School for the 2020-2021 cheer season.

Parent Name (print):__________________________ Cell#_________________Date:__________

Parent Signature:____________________________ Email:________________________________

Witnessed:_________________________________ ________________________________

WJB Cheer Coach WJB Cheer Coach

LEBANON SPECIAL SCHOOL DISTRICT EXTRACURRICULAR PERMISSION FORM

My child____________________________________, has permission to tryout and participate in the sport of cheerleading at Walter J. Baird for the school year 2020-2021.

MEDICAL RELEASE

This may be used to record parental permission for medical and surgical treatment in case medical emergencies arise during a field trip and or school sporting activity. Medical Insurance Co. ______________________________ Policy # ___________________

❏ Insurance is required to participate on the WJB Cheerleading Team.

Student Date of Birth______________________________________ Student Address_________________________________________ Phone_________________________________________________ Parent/Guardian_________________________________________Phone_______________ Family Physician’s Name_________________________________Phone________________ Address_________________________________________ City/State__________________ Allergies or Special Conditions__________________________________________________ __________________________________________________________________________

We, the undersigned as the parents or legal guardians of ___________________________ hereby grant to the Lebanon Special School District, its employees and agents the authority to seek medical care for our child. We further consent to any and all emergency medical and surgical treatments, including anesthesia and operations which may be deemed medically necessary by a qualified physician selected by agents or officials of the LSSD School Board. The intention thereof is to grant authority to administer and to perform all and singularly any emergency examinations, treatments, anesthetic, operations, and diagnostic procedures which may now or during the course of the patient’s care, be deemed medically necessary by any qualified physician. Witness of our consent and agreement to the matters above, we have subscribed our signatures below. In the event that you cannot be reached at the above numbers, please provide an emergency contact name and number below.

Contact Name:__________________ Number:____________ Relationship____________ Parent Signature:____________________________________ Date:__________________

*Byars Dowdy Elementary *Castle Heights Elementary * Coles Ferry Elementary*Sam Houston Elementary *Walter J. Baird Middle *Winfree Bryant Middle