La
“Carry The Light”
(Last) (First) (Middle)
Phone:_____________________________ Grade for 2010 season: 9 10 11
12
(Name) - (Relationship) - (Phone)
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The overall objectives of the Mavericks Football Program at La Costa Canyon High School are to develop:
Ø sport habits and skills sport understanding
Ø sportsmanship physical fitness
Ø a spirit of competitiveness the concept of team
Ø leaderships skills
All parents and student-athletes are asked to read and
discuss the implications of participation in
the Mavericks Football Program
before signing this form. This form must
be completed before permission is granted for participation.
1) Falsification of information.
2) Theft or vandalism of any school property.
3) Repeated acts of unsportsmanlike conduct.
4) Use of or possession of tobacco (all forms), alcohol, marijuana, any other illegal drugs or related paraphernalia, or the abuse of prescription or non-prescription drugs
A student athlete in the Mavericks Football Program will be subject to disciplinary action if he does not abide by the following four rules:
1) No Excuses
2) No Complaining
3) Be Responsible
4) Be Respectful
Not at any time does a member of the Mavericks Football coaching staff teach or encourage our student-athletes to use their helmet to make contact or deliver a blow. We do teach our student-athletes to keep their heads up and eyes open in order to see the target they intend to tackle or block. When contact is expected, we instruct our student-athletes to slide the helmet to the side of the opponent. Under no circumstances should any Mavericks Football player ever drive his helmet into an opponent. A warning appears on each of the player’s helmets as a further reminder of the risks of using the helmet in such a manner.
Our (My) son has our (my) permission to practice and compete in the sport of football. Our (My) son also has our (my) permission to participate in any off-season conditioning class either held during or after school. Our (My) son has our (my) permission to leave campus to participate in conditioning or summer passing-league activities under the direction of a teacher or coach. We (I) realize that such activities involve\ the potential for injury which is inherent in all sports, and on rare occasions a severe injury, including permanent paralysis or death. Each athlete is
responsible for any uniform and/or equipment issued him. Any uniform, lost or damaged other than ordinary wear and tear, must be paid for by the student-athlete or his parents. We (I) also understand and realize that participating in Mavericks Football has it’s expenses. We (I) will either through donations, volunteer work, or other Mavericks Football Fundraisers, participate equally to raise the necessary funds for these expenses before the dead period in summer. By signing below, we (I) are (am) granting permission for our (my) son to participate in the La Costa Canyon Football Program. We (I) also understand our (my) responsibilities as stated above:
Date:___________Parent Permission_____________________________________________________________
and Acceptance: (signature) (print last name)
I agree to conduct myself in accordance with the stipulations outlined in this participation form or any stipulations set forth to me by any member of the coaching staff. Failure to do so may result in disciplinary action.
Date:___________Student
Permission____________________________________________________________
and Acceptance: (signature) (print last name)
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I, the undersigned, know that participation in the La Costa Canyon Football is potentially hazardous to
the health of (Name)___________________________________. In choosing to participate in the La Costa Canyon Football Program I fully accept and assume all risks whether before, during or after completion of the league. These include without limitation, risk of physical injury, mental injury, emotional distress, trauma, death, contact with other participants, the effects of weather including extreme temperature or conditions. All risks are known and understood by me. I waive any and all specific notice of the existence of the risks. Knowing these facts and in consideration of my admission and participation in the La Costa Canyon Football Program, I, acting as parent or legal guardian release, waive, and agree to hold the Superintendent, San Dieguito Union High School District, La Costa Canyon High School, La Costa Canyon Foundation, its officials, emergency and support people, employees and representatives harmless from any claims, demands and actions of any kind I have, may have or may hereafter accrue against the released parties directly or indirectly arising out of or relating in any respect to participation in the La Costa Canyon Football Program. My waiver and release of all claims, demands, actions and liability shall include without limitation, any injury, damage or loss to my person or property which may be (a) caused by any act, or failure to act, by the above identified persons and entities or (b) sustained by my child before, during, or after the season.
I have read this agreement, waiver and release and agree to and accept the terms.
_____________________________________________________________________________________________
(Signature of Parent/Legal Guardian) (Typewritten or Printed Name)
_____________________________________________________________________________________________
(Name
of Participant in the League) (Date)
(SEE REVERSE SIDE)