1. education
2. school

LOUISVILLE HIGH SCHOOL
DEPARTMENT OF ATHLETICS
2011-2012 Athlete Forms
NAME OF ATHLETE:
__________________________
BIRTHDATE:
____/____/____
GRADE:
____
SPORT(S):
__________________________
*** Please do NOT take apart ***
Louisville Athletics
“Pre-Season Athletics Checklist”
2011-2012 School Year
Name of Student-Athlete:___________________________Sport(s):____________________
Parent/Guardian: (print name)
________________________________________________
Home Phone:_____________________________Cell/Work Phone:_____________________
Age_____________________ Birthday_____/_____/______ Grade__________________
Please download and read each item (listed below) from our website link: w ww.le ps.s p arcc. org Click
on “Athl etics ” and then click on “P re-S eas on At hletics ”. Once you have read/reviewed each item,
print this form, initial/date each item listed.
RET UR N T HIS SIG NED FO R M WITH YO UR ST UDENT- ATHL ETE t o his or he r c oach; your
son/daughter must return this signed form to their respective coach B EF ORE TH E FI RST OFFI CIAL
PRA CTI CE.
Your review of this data is a required condition of the OHSAA for your student to be eligible for
Louisville City Schools. If you have any questions please feel free to contact the Louisville High School
Athletic Department (330-875-5011) throughout the season.
Download, Read and Complete all of the following "Forms to be turned into
Athletic Office or Coaching Staff".
Initial
Date
____
____
____
____
____
____
____
____
___/___/___
___/___/___
___/___/___
___/___/___
___/___/___
___/___/___
___/___/___
___/___/___
A.
B.
C.
D.
E.
F.
G.
F.
Pre-Season Checklist Form
Pay to Participate Form (2 pages)
OHSAA Physical Examination, Health History, Authorization (4 pages)
Emergency Medical Authorization Form (2 pages)
Accident Awareness and Insurance Waiver
OHSAA Eligibility Guide and Sign Off Page (5 pages)
Weight Room Safety Student Acknowledgement Form
Review “Let's Get it Started” video
I have reviewed/received each of the above items and acknowledge the information contained
within.
________________________________________________
Signature of Parent/Guardian
_____________________
Date
LOUISVILLE CITY SCHOOLS
ATHLETIC DEPARTMENT
ATHLETIC HANDBOOK ~ CODE OF CONDUCT
2011-2012
♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦
Dear Parent/Guardian & Participant:
It is vital that all parties concerned ~ participant, parent/guardian, & school
personnel ~ work together with a clear & common understanding of the policies of
the Athletic Department. This knowledge will eliminate a lot of confusion & will
enhance the cooperation between home & school.
Please take the time to review the handbook/code of conduct & return this
SIGNED form to your son/daughter’s coach prior to any participation in any
Louisville Athletic program.
♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦
YES, we have received the Athletic Handbook & are aware of the policies &
procedures it contains.
______________________________ ______________________________
Participant’s Signature
Sport(s) Participating In ’11-12’
______________________________ ______________________________
Parent/Guardian Signature
Date Signed
LOUISVILLE
CITY
SCHOOLS
ATHLETIC POLICY
&
PARENT’S HANDBOOK
Adopted by Louisville Board of Education ~ May, 2009
LOUISVILLE HIGH SCHOOL
ATHLETIC POLICY
&
PARENT’S HANDBOOK
TABLE OF CONTENTS
SECTION
PAGE
1
STATEMENT OF PURPOSE
2
2
STUDENT ATTENDANCE
2
3
AWARDS & RECOGNITION
3
4
BOOSTER CLUB
4
5
CHEERLEADERS
5
6
SPORTSMANSHIP
5
7
N.B.C. FAN BEHAVIOR POLICY
8
8
ELIGIBILITY
8
9
OHSAA MANDATORY PRE-SEASON MEETING 10
10
ATHLETE’S COMMITMENT
10
11
ROSTER LIMITATIONS
10
12
SAME SEASON MULTI-SPORTS
10
13
STUDENT ISSUED EQUIPMENT
11
14
HAZING
11
15
CODE OF CONDUCT
11
16
TRANSPORTATION
13
17
WEIGHT ROOM
13
18
CALAMITY DAY POLICY
13
19
MEDICAL RELEASE FROM PHYSICIAN
14
20
SUNDAY PRACTICE
14
1
1.
STATEMENT OF PURPOSE
The purpose of this booklet is to compile information,
expectations and procedures so that we may share and obtain a common
goal of making the athletic programs of Louisville City Schools the
best possible.
Participating in any of the athletic programs of the Louisville
City Schools is a privilege not a right. The privilege of
participation can be lost due to certain circumstances. It is our hope
that this handbook can help answer questions on policies that are
present in our programs. While we understand that it is impossible to
foresee every possible situation that may occur, it is our goal to give
general guidelines that will ensure that all athletes can enjoy the
privilege of athletic participation. Individual coaches may have some
specific rules that apply to their teams.
Our extracurricular activity programs exist to benefit the
student and athlete in the following ways:
A.
We believe there are substantial educational outcomes from
soundly conceived and executed programs for the players,
the student body, and the school as a whole.
B.
We believe the potential values to the participants are
genuine. Rigorous competition under prescribed regulations
and policies provide for adolescent boys and girls the
opportunity to develop ideas and habits for health, fair
play, initiative, achievement, and emotional control.
C.
We believe athletes can be taught to win gracefully and to
lose in the same fashion.
D.
We believe that many athletes have found a purpose in their
schoolwork and in their lives through the program of
athletics.
E.
We believe that athletics provide for the student body
tangible values. Athletics can make a substantial
contribution to morale and can provide an outlet for
enthusiasm.
F.
We believe the athletic program, though differing in nature
from the academic program, does justify its existence by
providing a profitable, educational experience for the
participant. Furthermore, the same level of responsibility
and behavior is expected in extracurricular activities as
in the classroom.
G.
We believe the welfare of the individual athlete is always
to be the primary concern. The game exists for the athlete
– never the athlete for the game.
2.
STUDENT ATTENDANCE
In order to participate in a practice, a game, or a team
function: Students/athletes are to be here at least ½ of the school
day, including their final scheduled class mod. Some athletes
(seniors) might be done after 9th mod, while most have not completed
their scheduled classes until after 10th mod at 3:00 p.m.
If an athlete is ill in the morning, he/she must sign in by 11:45
a.m. and attend classes for the remainder of the day.
If an athlete becomes ill at school, he/she must stay in school
until at least 11:15 a.m., and then return for his/her final scheduled
mod of the school day.
2
Exceptions to this policy are: missing a school day due to a
funeral (note needed from parent), medical appointments (note needed
from medical source), and college visitation days (note needed from
admissions department).
Students/athletes who miss school on Friday may participate in
activities on Saturday.
3.
AWARDS & RECOGNITION
Each head coach will organize an awards night for his/her sport.
The head coach will work with the athletic secretary to help print a
program for the awards night. The date of each awards night should be
scheduled through the athletic office and should be as soon as possible
before the conclusion of the season. The cheerleaders will be part of
the football and boys basketball awards nights.
There are standard awards given for all sports. They are:
Freshmen Players
Reserve Players
1st Year Varsity
~
~
~
2nd Year Varsity
3rd Year Varsity
4th Year Varsity
~
~
~
Athletic Certificate
Athletic Certificate
Letter with insert of sport
{Girls ~ 6” Script L}
{Boys ~ 7” Block L}
Framed Certificate
Plaque of 3rd Year Award
Plaque (expanded)
Criteria for winning a letter:
Baseball ~ 25 varsity innings or participating in at least
½ of the games.
Boys’ Basketball ~ Participate in 20 quarters.
Girls’ Basketball ~ Participate in 20 quarters.
Cheerleading ~ Must cheer in 90% of the season’s quarters.
Boy’s Cross Country ~ 1st year/700 points; 2nd year/725
points; 3rd year/755 points; 4th year/800 points. Please see
Runner’s Handbook for further explanation.
Girl’s Cross Country ~ 1st runner/7 points; 2nd runner/6
points; 3rd runner/5 points; 4th runner/4 points; 5th runner/3
points; 6th runner/2 points; 7th runner/1 point, for running
in a varsity meet. With their years of experience points
will increase 5 points per year to letter. 9th grade/10
points; 10th grade/15 points; 11th grade/20 points. Seniors
in good standing who have been on the team for 3 years will
letter.
Football ~ Play in 20 quarters. A quarter is defined as
playing in two consecutive plays if one play involves being
on special teams. Also, coaches discretion. Seniors
letter.
Golf ~ Participate in 1/3 of the varsity matches.
Boy’s Soccer ~ Participate in 10 varsity game halves per
season.
Girl’s Soccer ~ Participate in 10 varsity game halves per
season.
Softball ~ 25 varsity innings, coaches discretion.
Swimming ~ 100% practice participation (two optional
practices will be offered each week to make up missed
3
practice time, private lessons will be offered by the
coach), compete in 50% of varsity meets, obey training
rules, earn 40 varsity points in the dual meet season or
qualify for districts.
Boys & Girls Tennis ~ 9th grade/play in 8 matches; 10th
grade/play in 6 matches; 11th grade/play in 4 matches; 12th
grade/play in 4 matches, unless on the team for 4 years,
then 2 matches.
Boy’s Track ~ Score 12 points. All seniors letter.
Girl’s Track ~ Score 12 points. All seniors letter if on
the team at least 3 years.
Volleyball ~ Participate in ½ of the varsity matches. All
seniors in good standing letter.
Wrestling ~ 3 varsity matches, 1 major tournament, and
coach’s discretion.
Trophies may be given by the coach for special awards, such as
M.V.P., Most Improved, etc.
Athletes will receive only one letter through their high school
career. If they receive a first year varsity award in a second sport,
they will receive only the insert pin for that sport to be put on their
letter. Statisticians and/or managers will receive a certificate for
participation for year’s one through three. Fourth year will be given
a plaque. The limit of statistician and/or managers will be six per
sport for combined varsity and reserve teams.
Each coach is responsible for keeping individual and team records
in their sport. A program will be typed by the athletic secretary for
each sport for the varsity teams to be used at their awards night.
The middle school coaches are to turn in a copy of such records
to the middle school athletic director. The middle school may have a
covered dish banquet or some appropriate function at their school for
an awards night. All middle school awards nights must have prior
approval of the middle school principal and the school will not be
responsible for any financial part of the banquet. There should not be
any banquet at which tickets are sold or a banquet at a restaurant.
The middle school award will be a certificate. Each middle
school coach is responsible for presenting the certificate awards to
his/her players at the Awards Day Assembly.
4.
BOOSTER CLUB
The Louisville Athletic Booster Club is an extension of our
athletic program to help supplement the needs of our athletes. Each
coach will deal directly with the booster club. The coach will make a
written request before the beginning of their season and get prior
approval from the booster club before spending any money. Some items
usually requested from the booster club are t-shirts, money for meals
or banquet, possible help on some equipment, etc. Always review your
requests with the athletic director before going to the booster club.
4
5.
CHEERLEADERS
The cheerleader advisor will conduct tryouts and have a selection
committee composed of college cheerleaders and/or cheerleading advisors
from other schools. The cheerleaders should be selected for the next
school year no later than the end of April. The cheerleader advisor
will update the cheerleading constitution periodically.
Varsity and reserve cheerleading policy:
A. Transportation ~ The athletic department will provide
transportation by bus.
B. Financial ~ Varsity uniforms are passed down to the reserve
cheerleaders. Each girl will provide her own shoes. The
cheerleaders will provide their own finances for paper and
supplies and for summer camp, if they so desire to attend.
They may have fundraisers with proper approvals.
C. Awards ~ Freshmen / Certificate; 1st & 2nd year Reserve /
Certificate; 1st year Varsity / Varsity letter; 2nd year
Varsity / Framed Certificate.
6.
SPORTSMANSHIP
(Guidelines for Coaches)
A.
B.
C.
D.
E.
F.
G.
H.
Teach good sportsmanship and demand that your players be
good sports.
Set a good example for players and spectators to follow,
maintain poise and self-control, and refrain from using
profanity at all times.
Respect the judgment of officials. Discuss disagreements
like ladies / gentlemen and shake hands with them before
and after the contest.
Educate your players that it is un-sportsmanlike to yell
intimidating remarks at the officials or the visiting
teams. Discipline, and remove from the contest if
necessary, any player who continuously displays poor
sportsmanship or poor conduct.
Be a good host to the visiting team, the coach, and the
crowd. Shake hands with the visiting coach before and
after the contest.
Avoid reprimanding a player in view of spectators or team
members.
Have a good relationship with the press and avoid making
intimidating remarks about officials or the opposing coach
or team.
Dress appropriately for the sport being coached.
(Guidelines for Players)
A.
B.
C.
D.
Treat opponents and officials with the respect that
is due them as guests and fellow human beings.
Shake hands with opponents before and after the
contest.
Take victory or defeat without undue emotionalism,
gloating, or show of disappointment.
Control your temper and refrain from using profanity
at all times, on and off the playing field or court.
5
E.
F.
G.
H.
Don’t argue with officials or criticize officials or
coaches after the contest.
Cooperate with the coach and fellow players in trying
to promote good sportsmanship.
Don’t swear or make insulting remarks to your
opponents, before, during or after the contest.
Tell the student audience that booing and insulting
remarks to officials is embarrassing to the team.
(Guidelines for Spectators)
Coaches may have to educate their fans in smaller sports.
A. Spectators will be expected to demonstrate the same
sportsmanship we expect from players and coaches.
B. Spectators are encouraged to be enthusiastic about our
team. Enthusiasm is contagious but does have limits
when it infringes on someone else’s rights.
C. Spectators have no right to harass players, game
officials, coaches or school officials, or in any way
abuse or slander another person.
D. Spectators are not permitted to use profane or abusive
language or gestures.
E. Spectators must respect the authority, decisions, and
judgment of our coaches.
F. Spectators must respect the property of the school and
the authority of school officials.
G. Be modest in victory and gracious in defeat.
H. Show self-control at all times before, during and after
the contest.
I. Generally, common sense, protocol, and courteous
behavior serve as the guidelines for fan deportment. We
would expect fans to conduct themselves in an acceptable
manner. This applies to such things as the wearing of
appropriate dress and shoes, showing courtesy to the
flag, and removing hats when attending indoor contests.
(Guidelines for Parents)
Reference: www.ohsaa.org
A. Make sure your children know that win or lose, scared or
heroic, you love them, appreciate their efforts and are not
disappointed in them. This will allow them to do their best
without fear of failure. Be the person in their life they can
look to for constant positive reinforcement.
B. Try your best to be completely honest about your child’s
athletic ability, competitive attitude, sportsmanship and
actual skill level.
C. Be helpful but don’t coach them. It’s tough not to, but it is
a lot tougher for the child to be flooded with advice and
critical instruction.
D. Teach them to enjoy the thrill of competition, to be “out
there trying,” and to be working to improve their skills and
attitudes. Help them develop the feeling for competing, for
trying hard, for having fun.
E. Try not to relive your athletic life through your child in a
way that creates pressure. You were frightened, backed off at
6
F.
G.
H.
I.
J.
K.
times and were not always heroic. Athletic children need their
parents, so do not withdraw. There is a thinking, feeling,
sensitive, free spirit in that uniform who needs a lot of
understanding, especially when their world turns bad. If they
are comfortable with you win or lose, then they are on their
way to maximum enjoyment.
Don’t compete with the coach. If your child is receiving mixed
messages from two different authority figures, he or she will
likely become disenchanted.
Don’t compare the skill, courage or attitude of your child
with other members of the team.
Get to know the coach(es). Then you can be assured that
his/her philosophy, attitude, ethics and knowledge are such
that you are happy to have your child under his/her
leadership.
Always remember that children tend to exaggerate, both when
praised and when criticized. Temper your reaction and
investigate before overreacting.
Make a point of understanding courage and the fact that it is
relative. Some of us climb mountains and are afraid to fly.
Some of us will fly but turn to jelly if a bee approaches.
Everyone is frightened in certain areas. Explain that courage
is not the absence of fear but a means of doing something in
spite of fear and discomfort.
Tell your doctor, trainer, coach and/or athletic administrator
if you have knowledge of any condition that would affect the
athletic performance of your child.
Communication You Should Expect From Your Child’s Coach
L. Philosophy of the coach
M. Expectations the coach has for your child as well as all
players on the squad
N. Locations and times of all practices and contests
O. Team requirements (fees, special equipment, off-season
conditioning)
P. Procedure should your child be injured
Q. Discipline that results in the denial of your child’s
participation
Communication Coaches Expect From Parents
R. Concerns expressed directly to the coach
S. Notification of any schedule conflicts well in advance
T. Specific concerns in regard to a coach’s philosophy and/or
expectations
Appropriate Concerns To Discuss With Coaches
T.
U.
V.
The treatment of your child, mentally and physically
Ways to help your child improve
Concerns about your child’s behavior
Issues Not Appropriate To Discuss With Coaches
W.
X.
Playing time
Team strategy
7
Y.
Z.
Play calling
Other student-athletes
Appropriate Procedures For Discussing Concerns with Coaches
AA.
BB.
Call to set up an appointment with the coach (contact the
athletic director to set up the meeting if unable to reach
the head coach)
Do not confront a coach before or after a contest or
practice (these can be emotional times for all parties
involved and do not promote resolution)
If The Meeting With The Coach Did Not Provide A Satisfactory Resolution
CC.
DD.
Call to set up an appointment with the athletic director
Determine the appropriate next step at this meeting
7.
N.B.C. FAN BEHAVIOR POLICY
Any fan that is ejected from an N.B.C. school-sponsored
interscholastic contest for unsporting conduct shall be denied
admittance to the contest for the remainder of the day. In addition,
the fan shall be denied admittance to any school-sponsored activity
until he/she attends an informal hearing with the athletic director and
principal. Following that meeting a suspension shall be determined
according to the seriousness of the infraction. The minimum suspension
is the denial of the next two regular season/tournament contests in the
same sport at the same level. This would include all contests at other
levels that are played in conjunction of the level of the ejection.
Example: Ejected from varsity basketball contest, a fan may not be in
attendance at next two junior varsity and varsity contests. If the
ejection occurs in the last contest of the season, the fan would be
denied admittance for the first two contests the following season.
8.
ELIGIBILITY
Eligibility will be determined by the policies adopted by the
Louisville Board of Education and O.H.S.A.A. The O.H.S.A.A. policy
states:
In order to be eligible, an athlete in grade 9, 10, 11 or 12 must
be currently enrolled and must have been enrolled in school the
immediately preceding grading period (nine weeks) and received passing
grades during that grading period in 5 subjects that earn a minimum of
1.0 credit per year towards graduation. The eligibility of an athlete
continues until the start of the 5th school day of the next grading
period, at which time the grades from the immediately preceding grading
period become effective. “In compliance with O.H.S.A.A. Bylaw 4-3-3,
the eligibility of a student shall be restored 24 hours after credit
grades are reported at 3 p.m. on the first full school day following
the end of the nine weeks.” An ineligible athlete may practice but not
dress or play in any scrimmages or contests.
An athlete enrolling in grade 7 for the first time will be
eligible for the first grading period (nine weeks) regardless of
previous academic achievement. Thereafter, in order to be eligible, an
athlete in grade 7 or 8 must be currently enrolled and must have been
enrolled in school the immediate preceding grading period and receive
8
passing grades during that grading period in 75% of those subjects
carried the preceding grading period which met five days per week or
its equivalent.
For eligibility purposes, the nine weeks grades are a matter of
record at the end of the grading periods. No grades can be made up
during the summer months to change eligibility.
STUDENT PARTICIPATION
A member of an interscholastic squad may not participate in any
workout, tryout, practice, or contest with a non-interscholastic squad
or as an individual in the same sport during the school’s season.
The definition of a scholastic squad member is any student who
participates in an interscholastic contest. A contest is a meet,
match, preview, game or scrimmage.
A member of an interscholastic squad may participate with a noninterscholastic team before or after the school’s season in the same
sport. There are specific O.H.S.A.A. rules to govern out of season
play. Please contact the high school athletic office before
participating. Each athlete must have a physical examination on the
form provided. The athlete and a parent must sign the form before the
athlete can practice. Additional forms may also be required.
The athlete is responsible to get his own physical and any cost
for the physical exam will be that of the athlete. The physical is good
for one calendar year from the date of the physical. Athletes may not
participate in any pre-season, in-season, or post-season activities
without a valid physical on file in the athletic office.
All 7th and 8th graders must have a physical on file in the office
of the middle school athletic director.
Before taking part in any athletic activity, every athlete
participating in each sport must have on file in the athletic office an
updated:
1.
O.H.S.A.A. Physical/Authorization/Eligibility/Code of
Conduct Form
2.
L.H.S. Insurance Waiver or School Insurance Form
3.
Last page of Athletic Policy Handbook; signed by
athlete & parent
4.
Emergency Medical Card
5.
Bigger, Faster, Stronger Student Acknowledgement Form
6.
Parent Pre-Season Checklist (must be returned to the
coach by the first official day of practice)
The head coach is responsible to have these forms collected
before practice begins and turned into the athletic secretary. No
athlete is allowed to begin practice until all forms are on file.
An emergency medical card and physical form must be filled out by
each athlete and signed by his/her parent. A copy of the emergency
medical card and a copy of the physical form must be at every practice
and contest. If an emergency occurs, the emergency medical card and
the physical must accompany the athlete for treatment unless the parent
goes with the athlete. A parent should be notified as soon as
possible. A coach or adult should accompany the athlete for emergency
treatment.
Any time an athlete is injured at practice or in a contest the
coach will complete an accident report within twenty-four hours. These
forms are available from your building athletic director.
9
9.
O.H.S.A.A. MANDATORY PRE-SEASON MEETING
The Ohio High School Athletic Association had made pre-season
parent information meetings mandatory before the beginning of each
individual athletic season. Policies of the OHSAA and the Louisville
City Schools are discussed and a video from the O.H.S.A.A. is to be
viewed. In an effort to make the pre-season meeting more convenient
for parents, the Louisville Athletic Department has received permission
from the OHSAA to add the meeting to its online menu. The information
may be found at the Louisville High School website, www.leps.sparcc.org
Find the scroll down box marked “Athletics” and scroll to pre-season
information. Follow the prompts to complete the forms and to watch the
OHSAA video. If you have any questions please call the Louisville
Athletic Department at (330) 875-5011. All pre-season information must
be completed and given to the coach before the first official practice.
10.
ATHLETE’S COMMITMENT
Once an athlete has been included on a team’s roster, he or she
may not quit the sport in order to join another team. The athlete may
not attend another sports conditioning or practice until the original
sports season is complete.
11.
ROSTER LIMITATIONS
Unfortunately, some of our teams must limit the number of
participants who may be included on a team’s roster. The possibility
does exist that an athlete who tries out for a team may not “make” that
team. Each coach has their criteria for evaluating prospective team
members.
12.
SAME SEASON MULTI-SPORTS PARTICIPATION
1. Purpose
A. To enhance the varsity sports program at Louisville High
School.
B. Encourage cooperation between sports programs.
C. Permit athletes to enlarge their scope of future
opportunities.
2. Guidelines
A. A contract signed by coaching staffs, athletes and
parents.
B. One sport is primary and one is secondary.
C. Athlete must declare a primary sport.
D. The secondary sport may not be a sport that uses a cut
policy.
E. The athlete must attend all practices, games,
scrimmages, meetings and responsibilities of the primary
sport before taking part in any activities of the
secondary sport.
F. The coaches of both sports must agree that they are
willing to share the athlete. The coach of the
secondary sport is under no obligation to accept the
athlete of a primary sport.
10
G. An athlete cannot switch primary sports during the
current season without forfeiting the right to
participate in both sports, except by mutual consent of
both coaches.
H. An athlete who quits either the primary or secondary
sport forfeits the right to participate in either sport,
except by mutual consent of both coaches.
I. The athlete must follow the rules of each sport.
13.
STUDENT ISSUED EQUIPMENT
All athletes are responsible for team issued equipment and
uniforms, whether purchased by the board of education, booster club or
team. All equipment and uniforms must be returned in satisfactory
condition. The athlete and/or the parents of the athlete are liable
for the replacement cost of any damaged or non-returned equipment or
uniforms.
14.
HAZING
It is the policy of the Louisville Athletic Department that
hazing activities of any type are inconsistent with the educational
process and shall be prohibited at all times. No coach or athlete
shall plan, encourage or engage in hazing. This includes all hazing of
a physical or psychological nature.
15.
CODE OF CONDUCT
O.H.S.A.A. rules supersede Louisville City Schools Athletic
Policy.
Student participation in the Athletic Program of Louisville High
School is a privilege. Each athlete and cheerleader is expected to
conduct himself/herself in an exemplary manner while a member of a
Louisville team or program. Team members shall adhere to the following
code of behavior above the student conduct code:
A. A season is defined as the period of time beginning with the
first day of official practice as listed in the O.H.S.A.A.
handbook through the conclusion of the last official athletic
contest or the conclusion of the team or league banquet,
whichever occurs later.
B. A contest is defined as one event no matter the number of days
in the event or the number of individual participations by a
competitor.
C. At no time during the season shall a competitor possess, use,
transmit, conceal, sell, be under the influence of, or smell
of alcohol or drugs. This also includes narcotics, mood
modifiers, counterfeit controlled substances (look-a-likes),
toxic inhalants, poisonous plants, drug related paraphernalia
and any dangerous chemicals.
D. There shall be no use or possession of tobacco products.
E. Any athlete who is arrested for, accused of, or convicted of a
felony crime shall be removed/suspended from participation in
any athletic activity pending further investigation and/or
court action.
F. Discipline for Competitors
11
1. First Offense ~ Any competitor found to be in
violation of these rules shall be immediately
suspended from participation in his/her current
sport/activity for a minimum of two weeks (14
calendar days). This suspension stipulates that the
athlete may not attend or participate in any
practices, contests, or team functions of any kind
for the duration of the suspension. **This suspension
will be reduced to a minimum of one week (7 calendar
days) under the following conditions:
a. The athlete agrees to undergo an assessment at a local
agency to determine the existence, if any, of an alcohol
or drug addiction.
b. If the assessment determines that there is a need for
treatment, the athlete must enroll in an appropriate
substance abuse program before being able to resume
his/her participation in an activity or on a team.
c. Failure to complete or meet the requirements of the
agreed upon program will result with an immediate
reinstitution of the remaining one week (7 calendar
days) suspension.
**After a hearing with the head coach/advisor, administrator,
parent, athlete and the reporting person, additional disciplinary
action could also be taken such as personal assessment, insight groups,
visits to professional agencies, assigned research projects, etc.
**If any of the above disciplinary options are refused, the
athlete will be immediately denied participation for the remainder of
the season.
2. Second Offense ~ Any team member violating these rules
for a second time will be immediately denied
participation for the remainder of the season.
3. Third Offense ~ Any team member violating these rules
for the third time will be denied participation in all
programs for the school year.
4. Written notification will be made with the parent(s)
after each offense.
G. All school and team suspensions shall run concurrently. When
a competitor is suspended from school (in-school suspension or
out-of-school suspension), the athlete may not attend any
practice sessions, contests, tournaments, or any school
function of any kind.
H. Discipline and Awards ~ If the awards night is during the twoweek (14 calendar days) suspension period, the athlete /
cheerleader forfeits his/her privilege to participate in the
awards ceremonies but is permitted to receive any awards
earned prior to the suspension. If an athlete / cheerleader is
suspended a second or third time during the season or refuses
or does not complete the alternative programs, he/she will
forfeit any awards or banquets related to the sport.
(Example: All County or N.B.C. League banquets, special
awards ceremonies away from the school, etc.)
I. Appeal ~ An appeal by the athlete shall be heard by the
athletic appeal board. This board shall consist of the
assistant principal, athletic director, a teacher appointed by
the principal, and a teacher appointed by the athlete. The
finding of the board and its recommendations shall be given to
the principal who will make the final decision.
12
J. Team Rules ~ The coach is encouraged to adopt other reasonable
training rules. These rules shall be given to the athletes
prior to the beginning of each season. Athletes who break
these rules may be disciplined but contact shall be made with
the administration and athletic director prior to dismissal
from the team. Coaches will complete a Denial of
Participation form when athletes are suspended or dismissed
from a team. The form will be kept on file in the athletic
office.
16.
TRANSPORTATION
The coach through the athletic office will request transportation
for buses and/or van. The athletic office will notify the bus garage
for requests.
The coach will give the time the bus is needed, approximate time
of return, and number of students to be transported. Whenever it is
necessary to cancel a contest it is the responsibility of the coach to
notify the athletic department. A bus is not to be scheduled before
the end of the school day unless prior approval has been received by
the school principal. The standard earliest time is 3:30 p.m.
Athletes are to be transported to and from athletic events on
board of education sponsored buses or vans. Emergency exceptions may
occur with the approval of the coach and/or athletic director.
17.
WEIGHT ROOM
The purpose of the Louisville Weight Room is to provide an
environment where strength and conditioning training and exercises may
take place under the supervision of Louisville Board of Education
approved coaches or staff. The room may not be utilized unless a board
of education approved coach or staff person is present to supervise.
All Louisville High School and Louisville Middle School athletes
must watch a video on safety before they may take part in any weight
lifting or conditioning program in our weight room. The athlete and
the athlete’s parent or guardian must sign that the athlete has viewed
and understood the safety video.
The Louisville Athletic Department uses the Bigger, Faster,
Stronger weight lifting and conditioning program for all of our
athletes. All coaches use the same exercises and techniques for all of
our athletes, which should result in a seamless transition from one
season to the next for multiple sport athletes.
The weight room is under surveillance at all times.
18.
CALAMITY DAY POLICY
On any calamity day (no school because of inclement weather or
other circumstances), all events and practices for all teams below the
varsity level are automatically cancelled. The only exception to this
would be for teams that are connected to the varsity. For instance, a
junior varsity team that shares players with the varsity may practice
with the varsity team. Another exception would be for a middle school
wrestling match that is connected to the varsity match. The middle
school wrestling team would compete that night unless the
administrators decide that conditions do not warrant them competing.
Middle school wrestling is not to practice if there is a calamity day.
13
Varsity events are not automatically cancelled if there is a
calamity day. The event may go on as scheduled if conditions permit.
No varsity practice is to begin before noon on a calamity day.
Coaches should make sure that safe conditions are present before they
hold their scheduled practice. Coaches should call the Louisville
Police Department and the Nimishillen Township Garage or road
superintendent. In addition, coaches need to contact the athletic
director to advise him of their plans and if they have checked with
authorities.
Parents have to give their consent for their child to travel to
practice or a game on a calamity day. If parents do not feel that
conditions are safe they should not allow their child to participate
that day. Parents need to communicate with the coach if they are not
giving permission for their child to participate.
19.
MEDICAL RELEASE FROM PHYSICIAN
When an athlete needs to seek medical attention for an injury or
illness the athlete must obtain a medical release from the treating
physician (M.D. or D.O.) before they can return to athletic activity.
The release needs to be given to the coach or athletic trainer. A copy
will be forwarded to the athletic office.
20.
SUNDAY PRACTICE
Louisville City Schools does not permit athletic teams to
practice or schedule contests on a Sunday without permission of the
Superintendent of Schools.
14
LOUISVILLE CITY SCHOOLS
Emergency Medical Authorization form ORC 3313.712
Purpose: To enable parents and guardians to authorize the provisions of emergency treatment for children who become
ill or injured while under school authority, when parent or guardian cannot be reached. This form is required by law to be
on file.
Please use Blue or Black ink.
Student Name_________________________________________________________ Home Phone #______________
Last
First
Middle
Address______________________________ City_____________________________ Zip________ Bus#_______
Sex - M / F
Grade_____
Home Room #_____
Date of Birth____________ School_____________________
Father s Name_____________________________________________ Father s Work # ________________________
Address (if different from student)____________________________ Home Phone # _________________________
E-mail address_____________________________________________ Cell/Pager # ___________________________
Stepmother s Name_________________________________________ Stepmother s Work #____________________
Mother s Name____________________________________________ Mother s Work # _______________________
Address (if different from student)____________________________ Home Phone #_________________________
E-mail address_____________________________________________ Cell/Pager Phone #_____________________
Stepfather s Name__________________________________________ Stepfather s Work #____________________
Guardian s Name_____________________________________________
Work Phone #___________________
(If other than parents)
E-mail address_______________________________________________
Cell/Pager #_____________________
Relative or other daycare provider:
Name_______________________________________________________
Daytime Phone #_________________
Person(s) who may be notified and to whom your child may be released if school cannot reach you. List in
preferred calling order.
1. _________________________________________ Relationship__________________ Phone #________________
2. _________________________________________ Relationship__________________ Phone #________________
3. _________________________________________ Relationship__________________ Phone #________________
If parents are divorced
or separated:
*Who has legal (court appointed) custody?_____________________________________
*Is there a restraining order? (Circle One) Yes No Against Whom:________________
*(A copy of these documents must be provided to the school)
(May require identification from these individuals)
Adults who have permission to pick up your child:
The following individuals may not pick up my child:
1.__________________________________________________ 1.___________________________________________
2.__________________________________________________ 2.___________________________________________
PLEASE COMPLETE THE REVERSE SIDE
Part I or II Must be Completed
Part I
TO GRANT CONSENT
I hereby give consent for the following medical care providers and local to be called:
Doctor s Name______________________________________________ Phone #_____________________________
Dentist s Name______________________________________________ Phone #_____________________________
Medical Specialist s Name_____________________________________ Phone #_____________________________
(for chronic health conditions)
Hospital (Preferred)__________________________________________ Emergency Room #____________________
In the event reasonable attempts to contact me have been unsuccessful, I hereby give my consent for (1) the
administration of any treatment deemed necessary by above-named doctors, or, in the event the designated preferred
practitioner is not available, by another licensed physician, or dentist; and (2) transfer of the child to any hospital
reasonably accessible.
This authorization does not cover major surgery unless the medical opinions of two other licensed physicians or dentists,
concurring in the necessity for such surgery, are obtained prior to the performance of such surgery.
Facts concerning the child s medical history including allergies, medications taken, and any physical
impairments to which a physician should be alerted:___________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
The School Nurse may share health information with appropriate school personnel to aid in present and future
education decisions.
Signature of Parent/Guardian_____________________________________________________ Date_____________
Part II
TO REFUSE CONSENT
(Do not complete if you completed Part I above)
I do not give my consent for emergency medical treatment of my child. In the event of illness requiring emergency
treatment, I wish the school authorities to take the following action:__________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Signature of Parent/Guardian_____________________________________________________ Date______________
Rev 4/06
x
Ohio High School Athletic Association
Preparticipation Physical Evaluation
DATE OF EXAM:_______________________________
Page 1 of 4
Name ___________________________________________________ Sex ___________ Age _______ Date of Birth ____________________________
Grade______ School ____________________ Sport(s) ______________________________________________________________________________
Address ______________________________________________________________________________ Phone ________________________________
Personal Physician____________________________________________________________________________________________________________
In case of emergency, contact:
Name ________________________Relationship ________________
Phone (H) __________________(W)_____________________(Cell)_____________________(Cell)__________________________
Email: ____________________________________________________________________
History
This section is to be carefully completed by the student and his/her parent(s) or legal guardian(s) before participation in interscholastic athletics in
order to help detect possible risks.
Explain "YES" answers in the space provided. Circle
questions you don't know the answer to.
1. Has a doctor ever denied or restricted you participation in
sports for any reason?
2. Do you have an ongoing medical condition (like diabetes or asthma)?
3. Are you currently taking any prescription or nonprescription
(over-the-counter) medicines or pills?
4. Do you have allergies to medicines, pollens, foods, or stinging insects?
5. Do you think you are in good health?
6. Have you ever passed out or nearly passed out DURING exercise?
7. Have you ever passed out or nearly passed out AFTER exercise?
8. Have you ever had discomfort, pain, or pressure in your chest
during exercise?
9. Does your heart race or skip beats during exercise?
10. Has a doctor ever told you that you have (check all that apply):
High Blood Pressure
A heart murmur
High Cholesterol
A heart infection
11. Has a doctor ever ordered a test for your heart? (for
example, ECG, echocardiogram)
12. Has anyone in your family died for no apparent reason?
13. Does anyone in your family have a heart problem?
14. Has any family member or relative died of heart problems or
of sudden death before age 50?
15. Does anyone in your family have Marfan syndrome?
16. Have you ever spent the night in a hospital?
17. Have you ever had surgery?
18. Have you ever had an injury, like a sprain, muscle or ligament
tear, or tendinitis, that caused you to miss a practice or
game? If yes, circle affected area below:
19. Have you had any broken or fractured bones or dislocated
joints? If yes, circle below:
20.
Have you had a bone or joint injury that required x-rays, MRI,
CT, surgery, injections, rehabilitation, physical therapy, a
brace, a cast, or crutches? If yes, circle below:
Upper
Hand /
Arm Elbow Forearm Fingers Chest
Head Neck Shoulder
Foot /
Upper Lower
Thigh Knee Calf/shin Ankle Toes
back back Hip
21. Have you ever had a stress fracture?
22. Have you been told that you have or have you had an x-ray
for atlantoaxial (neck) instability?
23. Do you regularly use a brace or assistive device?
24. Has a doctor ever told you that you have asthma or allergies?
Yes No
Yes No
25. Do you cough, wheeze, or have difficulty breathing during or after exercise?
26. Is there anyone in your family who has asthma?
27. Have you ever used an inhaler or taken asthma medicine?
28. Were you born without or are you missing a kidney, an eye, a testicle, or
any other organ?
29. Have you had infectious mononucleosis (mono) within the last month?
30. Do you have any rashes, pressure sores, or other skin problems?
31. Have you had a herpes skin infection?
32. Have you ever had a head injury or concussion?
33. Have you been hit in the head and been confused or lost your memory?
34. Have you ever had a seizure?
35. Do you have headaches with exercise?
36. Have you ever had numbness, tingling, or weakness in your arms or
legs after being hit or falling?
37. Have you ever been unable to move your arms or legs after being hit or
falling?
38. When exercising in the heat, do you have severe muscle cramps or
become ill?
39. Has a doctor told you that you or someone in your family has sickle cell
trait or sickle cell disease?
40. Have you had any problems with your eyes or vision?
41. Do you wear glasses or contact lenses?
42. Do you wear protective eyewear, such as goggles or a face shield?
43. Are you happy with your weight?
44. Are you trying to gain or lose weight?
45. Has anyone recommended you change your weight or eating habits?
46. Do you limit or carefully control what you eat?
47. Do you have any concerns that you would like to discuss with a doctor?
48. Record the dates of your most recent immunizations (shots)
Tdap _____________ MMR _____________
Chicken Pox __________
Hepatitis B_____________
Meningococcal____________
FEMALES ONLY
49. Have you ever had a menstrual period?
50. How old were you when you had your first menstrual period?
51. How many periods have you had in the last 12 months?
Explain "Yes" Answers Here: (Attach additional sheets as needed)
I (we) hereby state, to the best of my (our) knowledge, my (our) answers to the above questions are complete and correct.
Signature:
Signature:
Athlete
The student has family insurance
Yes
Date: ______________
Parent or Guardian (If athlete is under 18)
No; If yes, family insurance company name and policy number:
_________________________________________________
NOTE: CONSENT AND HIPAA RELEASE FORMS THAT MUST BE SIGNED BY BOTH THE PARENT AND THE STUDENT ARE ON A SEPARATE SHEET.
NOTE: HISTORY AND ALL CONSENT FORMS MUST BE COMPLETED PRIOR TO PHYSICAL EXAMINATION
Modified from 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, 2004. Rev. 03/10
Rev. 2/11
Page 2 of 4
Physical Examination Form
The section below is to be completed by physician or staff after history and consent forms are completed.
Students Name____________________________________________
Height______
Weight_________
Birth Date______________________________________
% Body Fat (optional)_________ Pulse_______ BP______/______, ______/______, ______/_____
Vision R 20/ __________ L 20/ __________
Corrected:
Y
N
Pupils:
Equal ________ Unequal _______
Follow-Up Questions on More Sensitive Issues (Optional)
1. Do you feel stressed out or under a lot of pressure?
2. Do you ever feel so sad or hopeless that you stop doing some of your usual activities for more than a few days?
3. Do you feel safe?
4. Have you ever tried cigarette smoking, even 1 or 2 puffs? Do you currently smoke?
5. During the past 30 days, did you use chewing tobacco, snuff, or dip?
6. During the past 30 days, have you had at least 1 drink of alcohol?
7. Have you ever taken steroid pills or shots without a doctor's prescription?
8. Have you ever taken any supplements to help you gain or lose weight or improve your performance?
9. Questions from the Youth Risk Behavior Survey (http://www.cdc.gov/HealthyYouth/yrbs/index.htm) on guns, seatbelts, unprotected sex, domestic violence, drugs, etc.
Notes:
MEDICAL
Normal
Abnormal findings
Initials*
Appearance
Eyes/ears/nose/throat
Hearing
Lymph nodes
Heart
Murmurs
Pulses
Lungs
Abdomen
Genitalia (males only)
Skin
MUSCULOSKELETAL
Neck
Back
Shoulder/arm
Elbow/forearm
Wrist/hand/fingers
Hip/thigh
Knee
Leg/ankle
Foot/toes
*Multiple-examiner set-up only.
Notes:
Clearance
Cleared without restriction
Cleared, with recommendations for further evaluation or treatment for:
Not cleared for:
Recommendations:
All Sports
Certain sports:
Reason:
Emergency Information:
Allergies:
Other Information:
Name of Physician: (print/type/stamp)
(M.D., D.O., D.C.)
Date:
If the Physician's Assistant (P.A.) or Advanced Nurse Practitioner (A.N.P.) performed the exam, name and address of collaborating physician or physician
group:
Address:
Phone:
Signature of Physician: _________________________________________________________________
Date:
Page 3 of 4
OHSAA AUTHORIZATION FORM
I hereby authorize the release and disclosure of the personal health information of _______________________________ ("Student"),
as described below, to ____________________________________ ("School").
The information described below may be released to the School principal or assistant principal, athletic director, coach, athletic trainer,
physical education teacher, school nurse or other member of the School's administrative staff as necessary to evaluate the Student's
eligibility to participate in school sponsored activities, including but not limited to interscholastic sports programs, physical education
classes or other classroom activities.
Personal health information of the Student which may be released and disclosed includes records of physical examinations performed
to determine the Student's eligibility to participate in school sponsored activities, including but not limited to the Pre-participation
Evaluation form or other similar document required by the School prior to determining eligibility of the Student to participate in
classroom or other School sponsored activities; records of the evaluation, diagnosis and treatment of injuries which the Student
incurred while engaging in school sponsored activities, including but not limited to practice sessions, training and competition; and other
records as necessary to determine the Student's physical fitness to participate in school sponsored activities.
The personal health information described above may be released or disclosed to the School by the Student's personal physician or
physicians; a physician or other health care professional retained by the School to perform physical examinations to determine the
Student's eligibility to participate in certain school sponsored activities or to provide treatment to students injured while participating in
such activities, whether or not such physicians or other health care professionals are paid for their services or volunteer their time to the
School; or any other EMT, hospital, physician or other health care professional who evaluates, diagnoses or treats an injury or other
condition incurred by the student while participating in school sponsored activities.
I understand that the School has requested this authorization to release or disclose the personal health information described above to
make certain decisions about the Student's health and ability to participate in certain school sponsored and classroom activities, and
that the School is a not a health care provider or health plan covered by federal HIPAA privacy regulations, and the information
described below may be redisclosed and may not continue to be protected by the federal HIPAA privacy regulations. I also understand
that the School is covered under the federal regulations that govern the privacy of educational records, and that the personal health
information disclosed under this authorization may be protected by those regulations.
I also understand that health care providers and health plans may not condition the provision of treatment or payment on the signing of
this authorization; however, the Student's participation in certain school sponsored activities may be conditioned on the signing of this
authorization.
I understand that I may revoke this authorization in writing at any time, except to the extent that action has been taken by a health care
provider in reliance on this authorization, by sending a written revocation to the school principal (or designee) whose name and address
appears below.
Name of Principal:
________________________________________________
School Address:
________________________________________________
This authorization will expire when the student is no longer enrolled as a student at the school.
NOTE: IF THE STUDENT IS UNDER 18 YEARS OF AGE, THIS AUTHORIZATION MUST BE SIGNED BY A PARENT OR
LEGAL GUARDIAN TO BE VALID. IF THE STUDENT IS 18 YEARS OF AGE OR OVER, THE STUDENT MUST SIGN THIS
AUTHORIZATION PERSONALLY.
____________________________________________________________________________________________________
Student’s Signature
Birth date of Student, including year
____________________________________________________________________________________________________
Name of Student's personal representative, if applicable
I am the Student's (check one): _______ Parent _______ Legal Guardian (documentation must be provided)
____________________________________________________________________________________________________
Signature of Student's personal representative, if applicable
Date
A copy of this signed form has been provided to the student or his/her personal representative
THE STUDENT SHALL NOT BE CLEARED TO PARTICIPATE IN INTERSCHOLASTIC ATHLETICS UNTIL THIS FORM HAS BEEN
SIGNED AND RETURNED TO THE SCHOOL
Page 4 of 4
2011-2012 Ohio High School Athletic Association Eligibility and Authorization Statement
This document is to be signed by the participant from an OHSAA member school and by the participant’s parent.
I have read, understand and acknowledge receipt of the OHSAA brochure entitled “Your Athletic Eligibility,”
which contains a summary of the eligibility rules of the Ohio High School Athletic Association. I understand that
a copy of the OHSAA Handbook is on file with the principal and athletic administrator and that I may review it,
in its entirety, if I so choose. All OHSAA bylaws and regulations from the Handbook are also posted on the
OHSAA web site at www.ohsaa.org.
I understand that an OHSAA member school must adhere to all rules and regulations that pertain to the
interscholastic athletics programs that the school sponsors, but that local rules may be more stringent than
OHSAA rules.
I understand that participation in interscholastic athletics is a privilege not a right.
Student Code of Responsibility
As a student athlete, I understand and accept the following responsibilities:
I will respect the rights and beliefs of others and will treat others with courtesy and consideration
I will be fully responsible for my own actions and the consequences of my actions
I will respect the property of others
I will respect and obey the rules of my school and laws of my community, state and country
I will show respect to those who are responsible for enforcing the rules of my school and the laws of
my community, state and country
I understand that a student whose character or conduct violates the school’s Athletic Code or School
Code of Responsibility is not in good standing and is ineligible for a period of time as determined by
the principal
Informed Consent – By its nature, participation in interscholastic athletics includes risk of injury and
transmission of infectious disease such as HIV and Hepatitis B. Although serious injuries are not common and the
risk of HIV transmission is almost nonexistent in supervised school athletic programs, it is impossible to eliminate
all risk. Participants have a responsibility to help reduce that risk. Participants must obey all safety rules, report all
physical and hygiene problems to their coaches, follow a proper conditioning program, and inspect their own
equipment daily. PARENTS, GUARDIANS OR STUDENTS WHO MAY NOT WISH TO ACCEPT RISK
DESCRIBED IN THIS WARNING SHOULD NOT SIGN THIS FORM. STUDENTS MAY NOT PARTICIPATE IN
AN OHSAA-SPONSORED SPORT WITHOUT THE STUDENT’S AND PARENT’S/GUARDIAN’S SIGNATURE.
I understand that in the case of injury or illness requiring transportation to a health care facility, that a
reasonable attempt will be made to contact the parent or guardian in the case of the student-athlete being a minor,
but that, if necessary, the student-athlete will be transported via ambulance to the nearest hospital.
To enable the OHSAA to determine whether the herein named student is eligible to participate in interscholastic
athletics in an OHSAA member school I consent to the release to the OHSAA any and all portions of school record
files, beginning with seventh grade, of the herein named student, specifically including, without limiting the
generality of the foregoing, birth and age records, name and residence address of parent(s)or guardian(s),
residence address of the student, academic work completed, grades received and attendance data.
I consent to the OHSAA’s use of the herein named student’s name, likeness, and athletic-related information in
reports of contests, promotional literature of the Association and other materials and releases related to
interscholastic athletics.
I understand that if I drop a class, take course work through Post Secondary Enrollment Option, Credit Flexibility
or other educational options, this action could affect compliance with OHSAA academic standards and my eligibility.
I understand all concussions are potentially serious and may result in complications including prolonged brain
damage and death if not recognized and managed properly. Further I understand that if my student is removed from
a competition due to a suspected concussion, he or she will be unable to return to competition that day without the
written authorization from a physician (M.D. or D.O.) or an athletic trainer which indicates that the student has not
been concussed..
By signing this we acknowledge that we have read the above information and that we consent to the herein
named student’s participation.
*Must Be Signed Before Physical Examination
__________________________________________________________________________________________________________________
Student’s Signature
Birth date
Grade in School
Date
__________________________________________________________________________________________________________________
Parent’s or Guardian’s Signature
Date
Rev. 2/11
LOUISVILLE HIGH SCHOOL
ATHLETICS
ACCIDENT AWARENESS AND INSURANCE WAIVER
NAME________________________________, _______________________
(Last)
(First)
Birth date___________________________
Grade_________________
I am aware that the chance exists that I may be seriously injured by my
participation in inter-scholastic athletics.
Louisville High School will NOT be held responsible for any medical
expense incurred as a result of injury while I am participating in interscholastic athletics. I will pay all medical bills.
Athlete's Signature______________________________Date_____________
Parent's Signature_______________________________Date_____________
2011-12 Edition
Student-Athlete
Eligibility Guide
Published by the
Ohio High School Athletic Association
Overview
Ohio High School Athletic Association
Scholarship
OHSAA Regulations On
Participating in your school’s interscholastic athletics
program will provide some of your most memorable
and enjoyable moments ever. Since your school is a
member of the Ohio High School Athletic Association,
there are standards that must be met in order to be eligible to compete.
You may attend any public or non-public high
school in which you are accepted when you enter
high school (grade 9) from a 7th-8th grade school.
In order to maintain eligibility for grades 9-12,
you must be currently enrolled in a member
school and have received passing grades in a minimum of five (5) one credit courses, or the equivalent, in the immediately preceding grading period.
The essential eligibility requirements in this publication
are only a summary of some of the regulations affecting
student eligibility. Most requirements are published in
the OHSAA Handbook, which can be found in the
offices of your principal and athletic administrator and
is posted on the OHSAA web site (www.ohsaa.org).
Your school district also has the authority to establish
additional academic standards and codes of student or
athletic conduct.
Seventh- and eighth-grade students must be currently enrolled in a member school and have
received passing grades in a minimum of five subjects that receive a grade or a pass/fail in the
immediately preceding grading period.
• A student becomes a member of an interscholastic squad, and thus establishes eligibility, when
he/she participates in a contest (scrimmage,
preview or regular season game).
• You may not use summer school grades for failing grades received or lack of courses taken in
the final grading period.
• Your semester or yearly grades have no effect on
OHSAA eligibility.
• Those taking postsecondary school courses must
comply with OHSAA scholarship regulations.
• The eligibility or ineligibility of a student continues until the start of the fifth school day of the
next grading period, at which time the grades
from the immediately preceding grading period
become effective. Note: Check with your principal or athletic administrator to determine the
exact date that eligibility will be restored.
Any questions you have concerning the OHSAA standards or your athletic eligibility should be reviewed
with your school principal or athletic administrator.
You should also meet with these administrators EVERY
TIME before you change your course schedule or drop
a course. Should you transfer schools, you must follow
up with your previous school and your new school to
ensure that all proper forms have been submitted to the
OHSAA.
The eligibility standards of the OHSAA have been
adopted by the member schools and were accepted by
your school when it became an OHSAA member. You
are urged, as a student-athlete, to study these standards
carefully since you are responsible for compliance with
these standards.
Best wishes as you learn the valuable lessons that come
with your participation in interscholastic athletics!
Student-athletes and parents have the opportunity to
ask school administrators and/or coaches questions
on OHSAA and school eligibility requirements, the
school’s Athletic Code of Conduct policy and other
issues during preseason meetings that the OHSAA
requires schools to hold no later than two weeks after
the beginning of each sports season. Meetings should
include showing a DVD prepared by the OHSAA that
reviews key student eligibility issues and discussion
on concussion management.
Transfers
OHSAA Regulations On
1
Once you establish your eligibility at a high school,
a transfer to a different high school will mean you
will be ineligible for athletics for one year from the
date of enrollment in the new school.
• There are several exceptions to this regulation.
To see if you qualify for an exception, you and
your parents should arrange a meeting with your
principal or athletic administrator.
• If your parent or legal guardian lives outside of
Ohio, you are ineligible unless one of the exceptions to the regulation is met. These exceptions
to the out-of-state residency rules are found in
Bylaw 4-6.
• If additional questions concerning these regulations remain, school principals or athletic
administrators should contact the OHSAA.
Awards
OHSAA Regulations On
You may receive awards as a result of athletic participation in interscholastic athletics from any
source. However, the value cannot be more than
$200 per award.
Amateurism
OHSAA Regulations On
You will lose your amateur status and forfeit your
eligibility if you:
• Compete for money or other monetary compensation.
• Capitalize on your athletic fame by receiving
money, merchadise or services.
• Receive expenses or compensation from a sponsor unless that sponsor is a recognized amateur
governing body or organization, recognized by a
member school or is your parent or guardian.
• Sign a contract or make a commitment to play
professional athletics.
• Receive services, merchandize or any form of
financial assistance from a professional sports
organization.
• Compete with a professional athletics team even
if no pay is received.
• Enter into an agreement with a sports or marketing agent.
Semesters
OHSAA Regulations On
After establishing ninth-grade eligibility, you are
permitted eight (8) semesters of athletic eligibility.
• The semesters are taken in order of attendance
once ninth-grade eligibility has been established.
• Semesters are counted toward eligibility
whether you participate in interscholastic athletics or not.
• There are exceptions to this regulation, so please
arrange a meeting with your principal or athletic administrator to review these exceptions.
Home Schooling
OHSAA Regulations On
If you are home schooled and also enrolled in an
OHSAA member school in accordance with the
school’s board-adopted partial enrollment policy,
you may be eligible for interscholastic athletics
participation at the school where you are enrolled
and attending.
• To be eligible, you must enter the OHSAA member school from the home school at the beginning of the school year after having been home
schooled for at least one calendar year.
• Failure to meet the one-year provision will
require you to be enrolled for a minimum of one
grading period before eligibility can be granted.
False Information
OHSAA Regulations On
If you compete under a name other than your own
or provide a false address, you immediately
become ineligible.
Open Gyms
OHSAA Regulations On
School officials may designate open gyms or facilities and the sports to be played. You may participate in open gyms or facilities provided:
• No one is limited from participating.
• No one is required to attend.
• No school officials invite selected students or
determine the teams.
• No school officials transport students to either
school or non-school facilities.
• No timing or written scoring is kept.
• No coaching or instruction is provided.
Age
OHSAA Regulations On
High school students (grades 9-12) who turn 19
years of age prior to August 1, 2011, are ineligible
for interscholastic athletics.
Seventh- and eighth-grade students who turn 15
years of age prior to August 1, 2011, are ineligible
for 7th-8th grade athletics but are eligible to participate in high school athletics.
• There are exceptions to this regulation, so please
arrange a meeting with your principal or athletic administrator to review these exceptions.
You may be declared ineligible for a maximum of
one (1) year for violating these rules.
2
ice hockey, soccer, softball and volleyball) may try
out, practice and compete on non-school teams
before and after the school season provided:
1. The number of students from the same school
on the roster of the non-school team is limited to
five (5) students in the sports of soccer, field
hockey and ice hockey; four (4) students in the
sports of baseball and softball; three (3) students in the sport of volleyball, and two (2) students in the sport of basketball. School football
team members are prohibited from competing
on non-school teams except from June 1 to July
31. Note: Seniors are exempt from these limitations after the conclusion of their sport season.
In addition, there is no limit on the number of
students from the same school team that may
participate on the same non-school team from
June 1 to July 31.
2. You have no contact with school coaches while
on a non-school team other than the 10 days
permitted between June 1 and July 31.
Instruction/Camps
OHSAA Regulations On
You may attend camps, clinics and workshops that
involve team play any time between June 1 and
July 31.
• Team play means there is more than one player
opposing one player.
• There is no limit on the number of students from
the same school team that may participate on the
same non-school team from June 1 to July 31.
You may receive instruction from a coach from a
school team only:
1. During the season of the sport, or
2. For 10 days only from June 1 to July 31.
Note: Interscholastic coaches in the individual
sports of bowling, golf, gymnastics, swimming &
diving and tennis may coach athletes from the
school where employed outside the interscholastic
season of the sport.
• You may be declared ineligible for the remainder of the school season for violating these rules
during the school season.
• You may be declared ineligible for the next season for violating these rules outside the school
season.
• A senior may be declared ineligible for the
remainder of the school year for violating these
rules.
Note: Check the OHSAA Sports Regulations
(available on the OHSAA web site) for the date
you must cease participation on non-school teams
in order to be eligible for OHSAA tournament
competition along with penalties for non-compliance with this date.
Individual skill instruction may be received in any
sport by a squad member at any time in individual
lessons provided that these individual skill
instructions do not violate any Board of
Education, school administrators’ or coaches’ policies. Again, however, the school coach may not
conduct individual or group lessons for a squad
member in a team sport except during June 1 to
July 31 and during the season of the sport.
Members of a school football team may play in
non-contact football contests and attend non-contact team football camps at any time between June
1 and July 31. Remember, however, that the 10day regulation for instruction from school coaches
is in effect.
Recruiting
OHSAA Regulations On
Note: It is a violation if a coach suggests your participation in an instructional program is mandatory.
You will be declared ineligible if you are recruited
by a person or group of persons to change schools.
Any attempt by you to recruit a prospective student-athlete for athletic purposes is also prohibited. A violation may also affect the eligibility of the
school team.
Non-School Teams
OHSAA Regulations On
A member of an interscholastic squad in a team
sport (baseball, basketball, field hockey, football,
ice hockey, soccer, softball and volleyball) may not
participate in an athletic contest, tryouts or any
type of team or group training or practices on or
with a non-school squad in a team sport in the same
sport during the school’s interscholastic season.
• In individual sports of bowling, cross country,
golf, gymnastics, swimming and diving, tennis,
track and field and wrestling, however, you may
practice and try out for a non-school team but
may not compete in a contest.
A member of an interscholastic squad in a team
sport (baseball, basketball, field hockey, football,
OHSAA Regulations On
Alcohol, Tobacco,
Drugs
You are prohibited from using any form of alcohol,
tobacco or illegal drugs at the playing site of an
interscholastic contest. The penalty is disqualification from that contest, and you will likely face
additional school and/or legal penalties.
3
Eligibility Checklist
OHSAA Regulations On
Steriods and PerformanceEnhancing Drugs
If you use anabolic steriods or other performanceenhancing drugs, you are ineligible for interscholastic competition until medical evidence
indicates that your system is free of these items.
OHSAA Regulations On
Preparticiation Evaluations
and Consent Forms
Each year you must submit a physical examination
form signed by a medical examiner before you
begin practice for a school sport. In addition, your
parents/guardian and you must sign the OHSAA
Authorization and Consent Forms.
• Procedures will be reviewed by school officials.
• Physical examinations are valid for one year
from the date of the exam except for those that
take place from May 1-June 1. Those exams are
valid for one year plus through the end of the
next school year.
Sporting Behavior
OHSAA Regulations On
You are expected to accept seriously the responsibility and privilege of representing your school
and community while participating in interscholastic athletics. You are expected to:
• Treat opponents, coaches and officials with
respect.
• Display no behavior that could incite fans or
other participants in the contest or which is
intended to embarrass, ridicule or demean others under any circumstances including on the
basis of race, religion, gender or national origin.
• Remember that winning isn’t everything.
Having fun, improving your skills, making
friends and doing your best are also important.
The OHSAA has established a policy for students
ejected or disqualified for unsporting behavior or
flagrant fouls. If you are ejected or disqualified:
• You will be ineligible for all contests for the
remainder of that day, and
• You will be ineligible for all contests at all levels
in that sport until two regular season/tournament contests are played at the same level as the
ejection (one contest in football).
If you are ejected or disqualified a second time in
a season, you are subject to additional, stiffer
penalties, including suspension from play for the
remainder of the season in that sport.
Note: The complete OHSAA ejection/disqualification policy for unsporting behavior can be found
in the OHSAA Handbook and is posted on the
OHSAA web site (www.ohsaa.org).
OHSAA High School
Before you play, you must be eligible. Please review the
following checklist with your parents. Unchecked boxes
will likely mean you are NOT eligible. For questions, see
your principal or athletic administrator.
q I am officially enrolled in an OHSAA member high
school.
q I am enrolled in at least five one credit courses or the
equivalent, each of which counts toward graduation.
q I received passing grades in at least five one credit
courses or the equivalent, each of which count
toward graduation, during my last grading period.
q I have at least one parent living in Ohio.
q I have not changed schools without a corresponding
move by my parents or legal guardian or by qualifying for one of the exceptions to the OHSAA transfer
regulation.
q If I have changed schools (transferred), I have followed up with my previous school and my new
school to ensure that all proper forms have been
submitted to the OHSAA.
q I have not been enrolled in high school for more than
eight semesters.
q I did not turn 19 before August 1, 2011.
q I have not received an award, equipment or prize
valued at greater than $200 per item.
q I am competing under my true name and have provided my school with my correct home address.
q I have not competed in a mandatory open
gym/facility, conditioning or instructional program.
q I have not been coached or provided instruction by a
school coach in a team sport or cross country, track
& field and wrestling other than during my sport
season or for no more than 10 days between June 1
and July 31 (applies to team sports only).
q I am not competing on a non-school team during my
school team’s season.
q I have not been recruited to attend this school.
q I am not using anabolic steroids or other performance-enhancing drugs.
q I have had a physical examination within the past
year and it is on file at my school.
q My parents and I attended a preseason meeting at
my school which the OHSAA requires to be held no
later than two weeks after the beginning of each
sports season. We viewed a DVD prepared by the
OHSAA to review key eligibility issues and address
sporting behavior.
q My school reviewed its concussion management
protocol and my parents and I reviewed a short presentation on concussions that is available at no cost
at www.nfhslearn.com.
q My parents and I have signed the OHSAA
Authorization Form and the OHSAA Eligibility and
Authorization Statement and they are on file at my
school.
4
Louisville City School District
Department of Athletics
Pay to Participate
All high school and middle school students who wish to be involved in athletics
will be charged a participation fee for the 2011-2012 school year. The fee for high
school is $100 and for middle school the fee is $25. These figures are the cap amounts
that a student will pay for their participation in athletics, clubs and activities. Once you
have met your cap amount, there will not be any additional PTP fees. Instructional
course fees and general fees do not count against the Pay to Participate cap. As of
September 8, 2008, students who qualify for free or reduced lunch will not be required to
pay the PTP fee.
Guidelines
1. The superintendent or his designee will determine if there are too few participants
to field a team. Should the sport be discontinued, all fee money will be refunded.
2. Persons or organizations wishing to offer aid or “scholarships” to students should
do so directly through the student’s family.
3. The payment of a PTP fee does not guarantee any athlete a certain amount of
playing time, special recognition, awards or athletic letters.
4. Fees are non-refundable with the following exceptions:
A. Sport is cancelled due to insufficient numbers.
B. Student does not make the team.
C. A student becomes disabled prior to the date of the first regular season
contest/game.
D. Student moves out of the school district prior to the first regular season
contest/game.
E. Student is declared academically ineligible before the first contest/game
5. There will be no refunds for students who are suspended or removed for
disciplinary reasons, or for students who quit for any reason after the sport’s first
official practice.
Correspondence and/or payments can be brought to the appropriate school or can be
mailed to:
Athletic Fee
Louisville High School
1201 South Nickelplate Avenue
Louisville, OH 44641
Athletic Fee
Louisville Middle School
1300 South Chapel Street
Louisville, OH 44641
Please contact the following individuals with questions and/or comments:
High School – Rich Venuto or Lisa Devereaux (330) 875-5011
Middle School – Garth Evans (330) 875-5597
June, July, August {summer months} – (330) 875-1438
Louisville City School District
Department of Athletics
Student Name: __________________________________________
Address: ______________________________________________
Grade: _____________
Phone: _____________
Activity Fee: {Please indicate the sport}
High School Sport:
Middle School Sport:
_________________________
_________________________
Fee: $100.00
Fee: $ 25.00
Waiver Request:
I request that all or a portion of the PTP fee is waived for the following reason:
_____ Played sport in previous season (2011/12) and have already reached individual cap.
Sport played _________________________
_____ Free or reduced lunch (form on file with school cafeteria).
_____ Other P2P previously paid. Please list clubs and activities previously paid.
Note: Instructional course fees and general fees do not count against cap.
_________________________ $_____
_________________________ $_____
_________________________ $_____
Enclosed is a check/money order/cash for $__________
(Checks made payable to: Louisville City School District)
Please read and sign below.
I have read the guidelines set forth by the Louisville City School District regarding the
Pay to Participate Policy. I agree to abide by these regulations and to allow my son/daughter to
participate in this program.
Parent Name:
Parent Signature:
___________________________
___________________________
Date:
_____________
Deadlines for 2011-2012 school year are:
Fall Sports
Winter Sports
Spring Sports
Office Use Only
July 29, 2011
October 28, 2011
February 24, 2012
Date paid:
Check:
Receipt:
Amount Paid:
{CC, CH, GF, FB, SC, TN, VB}
{BKB, CH, SW, WR}
{BSB, SB, TN, TR}
_______________
_______________
_______________
_______________
Cash
Money Order
BIGGER FASTER STRONGER
Dedicated To Helping
Athletes Succeed
Weightroom Safety
Student/Athlete Acknowledgement Form
I ___________________________________________________________________
Print student/athletes’ name
Acknowledge that I have seen and knowledge of the following safety features for our
weight training/fitness class
___________ I have seen the BFS Weightroom Safety Video.
Initial here
___________ I have read the BFS Weightroom Rules Poster.
Initial here
___________ I am familiar with the three BFS Safety Posters describing the Knee,
Initial here
Hamstring, and Back safety.
___________ I have seen the Training Posters and know that I have the responsibility
Initial here
to read each on carefully to learn the correct techniques of the squat,
bench, clean, deadlift, and the quick lifts.
___________ I know that additional information on correct lifting technique and
Initial here
other strength and conditioning topics is available at
www.biggerfasterstronger.com.
___________ I have been instructed in the proper use of all equipment in the facility.
Initial here
___________ I have read and understand the disclaimer below.
Initial here
____________________________________________
____________
Student/athletes’ signature
date
____________________________________________
____________
Coach’s signature
____________________________________________
Parent or legal guardian signature
date
____________
date
DISCLAIMER: Although weightlifting is one of the safest athletic activities, all athletes run the risk of being
injured. It is the intention of the “BFS Safety package” to inform coaches, athletes and students of the possible injuries
associated with the weight room and lifting weights. This form and the information described therein is intended solely
as instruction on how to minimize injury potential due to lack of knowledge or instruction. Bigger, Faster, Stronger,
Inc. holds no responsibility, whether stated or implied, for athletes or students who may receive injuries whether or not
they are following the guidelines stated above.