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Wayland-Cohocton
 Central School
2350 Rte 63 N  
Wayland NY 14572

(585)728-2211

 

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Interscholastic athletic offerings

 

 

Fall

FOOTBALL                                          vArsity, JV, Modified

BOYS SOCCER                                     vArsity, JV, Modified

GIRLS SOCCER                                    vArsity, JV, Modified

BOYS CROSS COUNTRY                       vArsity, MODIFIED

GIRLS CROSS COUNTRY                      vArsity, Modified

GIRLS VOLLEYBALL                             vArsity, JV, Modified

GIRLS SWIMMING                                vArsity

GIRLS TENNIS                                     vArsity

 

WINTER

BOYS BASKETBALL                              vArsity, JV, Modified

GIRLS BASKETBALL                             vArsity, JV, Modified

CHEERLEADING                                  vArsity, JV, Modified

WRESTLING                                        vArsity, JV, Modified

BOYS SWIMMING                                vArsity, Modified

BOYS ALPINE SKIING                          vArsity, Modified

GIRLS ALPINE SKIING                          vArsity, Modified

COED INDOOR TRACK                         vArsity

 

SPRING

baseball                                           vArsity, JV, Modified

softball                                           vArsity, JV, Modified

boys track & field                          vArsity, Modified

Girls track & field                         vArsity, Modified

boys tennis                                     vArsity, Modified

boys golf                                         vArsity, JV, Modified

 

 

TO GET SCHEDULES FOR ANY ATHLETIC TEAM:

 

  • Go to the school website- www.wccsk12.org
  • CLICK ON ATHLETICS
  • CLICK ON SPORTS CALENDAR
  • SCROLL DOWN TO SELECT SPORT & LEVEL
  • CLICK VIEW SCHEDULE
  • IF YOU WOULD LIKE TO BE NOTIFIED OF CHANGES, CLICK SIGN UP HERE UNDER SIGN UP TODAY!
  • FOR DIRECTIONS TO OTHER SCHOOLS JUST CLICK ON THE OPPOSING SCHOOL

WAYLAND-COHOCTON CENTRAL SCHOOL

ATHLETIC AWARDS SYSTEM

 

1.                  Athletes must successfully complete a JV season to be recognized.

 

2.                  Athletes must successfully complete a Varsity season to be recognized.

*If the athlete does not complete the season or all necessary requirements, they will receive no credit.

WE DO NOT ALLOCATE PARTIAL CREDIT!

If a sport does not have a JV team, then the coach has the option of giving JV or Varsity credit.

This decision is left to the discretion of the head coach. 

 

3.         Managers—in order to receive points they must attend all practices and games, just as though they were an actual player.  If they are only there for games, then they cannot receive credit.

 

4          The Award System is as follows:

A.     Selective Classification Athletes receive credit toward sport participated.

B.     Numerals for participation:  Freshman Year.

C.     Minor Letter—small “wc” given to athletes who have participated at the JV level for 2 years  (One per athlete for high school career):  Sophomore Year

D.    Pins given to athletes who have participated at the Varsity level:  Junior Year

E.     Major Letter—Large “WC” given to athletes who have participated at the Varsity level for 2 years (One per athlete for high school career) Senior Year

F.      Tri-Athlete Award – participation in 3 sports Senior Year

G.    WCCS Golden Eagle Award—Plaque awarded to athletes who have participated in 3 sports for 3 years or 2 sports for 4 years.

H.    Ralph Porrazzo Athletic Achievement Award—Trophy awarded to athletes who have participated in 3 sports for 4 years.

I.       Additional Awards:

1.      MVP (Most Valuable Player)—chosen by the coach of each varsity sport

2.      Outstanding Athlete of the Year Award—chosen by the coaching staff

3.      Rich Martello Ability and Sportsmanship Award—chosen by the coaching staff

4.      Senior 4 Year Contribution Award—chosen by the coaching staff

5.      Kyle Costello Junior Memorial Award—Athletic participation/academics achievement—chosen by coaching staff.

6.  Daniel Averill Memorial Scholarship

7.      Special Awards—coaching staff


 

WAYLAND-COHOCTON ATHLETIC DEPARTMENT

 

Dear Parent or Guardian:

 

Your son/daughter would like to become a member of an athletic team.  It will be a privilege to coach your son/daughter, as well as a privilege for your son/daughter to be a member of a team.

 

The following rules and regulations are to be followed by all athletes while participating on an athletic team:

 

  1. Rules, regulation and standards established by the Wayland-Cohocton Central School Administration must be followed according to:
    1. Grades 5-12 Extra-Curricular Activities Eligibility Policy (see attached)
    2. Academic Eligibility Policy (see attached)

                                                              i.      High School

                                                            ii.      Middle School

    1. Parent – Coach Relationship
  1. Each athlete is responsible for the safekeeping and care of athletic equipment that is issued to him/her.  No athlete may compete in another sport until all issued equipment is turned in from the prior sport.
  2. Coaches will establish their rules on curfews, cutting practices and team discipline.  Athletes will be informed at the beginning of each season of these rules and violation of the coach’s rules could lead to suspension from the squad.
  3. Athletes and parent/guardians are responsible for reporting any injury sustained during a practice or game to their coach and the health office.
  4. Athletes are to have reported to the nurse’s office prior to the beginning of the season to receive proper paperwork regarding physicals.  Athletes are required to have had a physical before beginning the sport season.
  5. The attached forms are to be signed and returned to the coach as soon as possible:  the signature form indicating that you and your son/daughter have reviewed the extra-curricular and academic policies and the parental authorization and waiver of claims form for the usage of the fitness center.
 

 

Activities

SUBJECT: GRADES 5-12 EXTRACURRICULAR ACTIVITIES ELIGIBILITY POLICY

Scope

These rules of eligibility have been established for the benefit of our extra-curricular participants. If our school is to excel in extra-curricular activities and competitions, we must first discipline our conduct and behavior as individuals; then as a team; and then as a school. This policy is in effect in and out of a sport/activity season. If you are not currently participating in an extra-curricular activity and violate this policy, the penalty will be imposed on the date that determination is made and may affect future participation. Extra classroom events, as determined by Administration, for example but not limited to Sr. Trip, Jr. Prom, Sr. Ball are not included within the scope of this policy, but will be dealt with through District discipline policies.

Determination of Consequences

The Athletic Director/Dean of Students will make a decision on the penalty. The District reserves the right to determine any appropriate penalty based on the severity, nature and circumstances of a violation including other violations by that particular student. Based upon the individual circumstances, the Athletic Director and Dean of Students will give consideration to those students cooperating in the investigation.

Notification of Penalty

The student and the parent will be notified by either the Athletic Director or Dean of Students within a reasonable amount of time of the determination of the suspension or dismissal, and also inform them of their appeal procedure if desired.

If an interpretation or a ruling is required, the line of responsibility is the Athletic Director/Dean of Students, then the Principal, and finally the Superintendent of Schools. The Athletic Director will handle all issues concerning athletes and the Dean of Students will handle issues concerning all other extra-curricular activities. All suspensions and dismissals will begin the day they are issued and run for the designated amount of time. It is important to read this policy. Your child may be suspended from all extra-curricular activities for up to forty (40) school weeks. Violations and all subsequent penalties will carry over from school year to school year.

Extra-curricular activities are defined as the participation in all non-credit bearing activities during the school day or after the school day including practices and competitions.

General Rules

a) Attendance: Students are required to attend all classes during the school day in order to participate in extra-curricular activities after school. The exception is made for a bona fide appointment such as dentist, doctor, court, or college visitation accompanied by an appropriate excuse, which must be provided to the attendance clerk immediately upon arrival at school.

1. Absences: If a student is illegally absent, truant, suspended in or out of school, or excused from any part of the school day due to illness, (s)he may not participate in any extra-curricular activity that day.

2. Tardy: A student, who is late to school, is considered tardy. (S)He will sign in at the attendance office. If tardiness has been an ongoing issue (defined as three [3] or more unexcused tardies during a sports/activities season), the student will not be allowed to participate in that day's activity. A student must be in school by 9:30 a.m. in order to practice or participate in that day's event, unless they have a legal excuse as determined by the attendance officer.

3. Absence Following Extra-Curricular Events: Each student must make every effort to be in school the school day following an extra-curricular activity. If a pattern of absences develops following an extra-curricular activity, the coach/advisor will take appropriate disciplinary action. If absences after an extra-curricular activity have been a problem, participation in the next scheduled activity may be suspended.

b) Activity Rules: In addition to the extra-curricular rules set forth in this policy, the individual coach/advisor may establish rules for the activity above and beyond what is outlined in this policy. These rules cannot supersede any rules contained in this policy. These rules must be provided in writing to both the parents and students at the beginning of the season/activity. A copy will also be given to the Athletic Director and Principal. Some areas regulated by the coach/advisor rules may be, but are not limited to, curfews, late arrivals, or insubordination to the coach/advisor. Exceptions to the rules established by the coach/advisor may be made by the coach/advisor after conferring with the Athletic Director/Dean of Students. Violations to these rules may range from a warning, to suspension, to dismissal from the extra-curricular activity.

c) Violation Reports: Extracurricular activity student code violation reports will be accepted from coaches, administrators, teachers, school personnel and police officers as well as other "reliable sources" as determined by administration.

d) Drugs, Alcohol and Tobacco: Any student in possession of**, using, or distributing (selling) any controlled substance (drugs, alcoholic beverages, tobacco, steroids) will be subject to discipline under this policy. The District reserves the right to determine an appropriate penalty. (See determination of consequences section.) The following will be generally applicable.

For the basis of interpreting the next section violations will begin accruing when a student becomes eligible or selectively classifies to participate in a Junior varsity or Varsity sport.

**Possession includes knowingly being in close proximity to and/or actual control of a controlled substance as defined above.

1. A first policy violation will result in student being ineligible to participate for ten (10) school weeks.

(a) Athletics - students will still be eligible to practice at the discretion of the individual coach. If the suspension exceeds twenty-five percent (25%), or more, of the scheduled contests the student will be dismissed from the activity.

(b) Non-Athletic activities - students will still be eligible to practice at the discretion of the individual advisor. The student will be excluded from activities that are scheduled during the ineligibility period. Participation may resume at the end of the ineligible period or conclusion of activity.

2. A second violation of the policy, the student will be ineligible to practice/participate for twenty (20) school weeks. The student will be dismissed from the activity.

3. A third violation of the policy, the student will be suspended from all extracurricular activities for a period of forty (40) school weeks, with no chance of lessening the period of the suspension. Any subsequent violations will also result in a 40-week suspension.

At the discretion of the District the period of suspension may be lessened only in a first or second offense situation and then only if the student verifies that (s)he has attended the 3-hour CASA workshop on alcohol/drug abuse. In the discretion of the District this may lessen the period of suspension by no more than half of the weeks of suspension. The student and/or parents should speak with the Athletic Director/Dean of Students to obtain an appropriate referral for counseling.

e) Attending Parties: Students are prohibited from being present at any party where minors are illegally consuming drugs and/or alcohol. Remaining "present" means the student becomes aware or reasonably should have been aware, that alcohol or drugs were being consumed and that (s)he failed to leave the party. If a violation is verified, the student will be subject to a seven (7) calendar day suspension from the activity for the first incident. Subsequent violations and the resulting penalties will be subject to the District's discretion based upon the circumstances.

f) Self-Referrals: If a student self-refers for assistance in dealing with his/her alcohol or other drug use, (including tobacco) he/she will be referred to a Substance Abuse Coordinator or school counselor and given one-time amnesty from discipline if the following conditions are met: (1) He/she voluntarily acknowledges the problem before the investigative process begins, (2) Enrolls in a "program" described above, and (3) Continues with the program until discharged. A No-Use Contract will be signed but will not constitute an offense. If the student does not follow his/her recommended treatment program, he/she will be subject to the foregoing regulations regarding extra-curricular activities. This section does not apply to a student being investigated under Sections d) or e).

g) Behavior and Conduct of Participants: Good community citizenship is required of all participants of extra-curricular activities. Good community citizenship involves following a high standard of behavior and conduct while in or out of the school setting. Students are expected to follow all laws, school and government regulations. Any student who is arrested or receives an appearance ticket from a law enforcement officer must report that incident immediately to his/her coach/advisor or the Athletic Director/Dean of Students. Failure to do so will constitute a violation of this policy. Any student who is arrested or receives an appearance ticket by police may be suspended from all extra-curricular activities until the Athletic Director/Dean of Students can investigate the infraction and a decision made on further participation. In addition, extra-curricular participants who have been found to violate the law and/or violate the school's disciplinary code will be subject to consequences under this policy as determined by the Athletic Director/Dean of Students.

h) Returning School Property: Any student in possession of any school athletic equipment/ costumes/or activity property or uniform will not be permitted to participate in another extra-curricular activity until all property has been returned or restitution is made.

i) Academic Eligibility: Please refer to administrative policies: Wayland-Cohocton Central School Academic Eligibility Policy-High School and Wayland-Cohocton Central School Extra-Curricular Academic Eligibility Administrative Policy-Middle School.

j) Physical Education Requirements for Athletes: Athletics is an outgrowth of the Physical Education program. Those students demonstrating outstanding skill, attitude, and effort are those encouraged to participate in athletics. Because of the importance of Physical Education all athletes will be required to participate in Physical Education throughout the year.

If an athlete receives a written referral for conduct in a physical education class, lack of participation, or truancy (illegal absence), (s)he must attend practice or the game, but is ineligible to participate in the day's practice session or game. Parents will receive a copy of the written warning. The Physical Education teacher will notify the Athletic Director who will in turn notify the coach. A student dropped for conduct or truancy from Physical Education will be ineligible to participate in athletics. N.Y.S.P.H.S.A.A. regulations state that a student must be enrolled in Physical Education to participate in athletics.

Appeal Procedures

If the student and his/her parents wish to appeal the disciplinary action by the Athletic Director/Dean of Students, the Principal must be notified in writing within one (1) week (seven [7] calendar days) after issuing the disciplinary decision. The Principal will schedule a meeting within one (1) week (seven [7] calendar days) of the appeals request and issue a written decision within seven [7] calendar days of the meeting. If appealing the decision of the Principal, written notice must be given within seven (7) calendar days of the decision to the Superintendent of Schools. The Superintendent will issue a written decision within seven (7) calendar days of receiving the notice of appeal. The final step of the process of appeal is with the Board of Education. The Office of the Superintendent must receive an appeal to the Board of Education within seven (7) calendar days of receipt of the Superintendent's decision. The Board of Education will hear appeals within the next two (2) scheduled meetings.

Adopted: 6/20/11

 

 

Middle School Extra-Curricular Academic Eligibility Policy

 

Extra-curricular activities require a tremendous amount of student time and effort.  The academic and vocational education of our students is the primary function of our school.

 

In order to participate in any * extra-curricular activity, a student must be encouraged to earn and maintain passing grades in his/her academic program of studies.  In September of each academic year, all students will be eligible to participate in all extra-curricular activities.  At the beginning of each activity, advisors/coaches will submit to the office a roster of students participating in their activity. 

 

At 5-week increments, based on the interim reports and report cards, the list will identify students who are failing subjects. 

 

Students who are failing one class will be allowed to practice and play, if they stay for assistance 13th period.

Extra-Curricular “green passes” will be used by the staff to communicate practice and playing privileges to the activity supervisor.

If the student does not stay 13th period to improve their grade, they will not be able to practice or play.

 

Students who are failing two will be allowed to continue to practice, only.  After a two-week minimum ineligibility period, it will be the individual teachers prerogative to release a student from the ineligibility list (based on effort and attitude to improve grade). The Middle School Principal/Dean will review each release for the final decision to participate in extra-curricular events.

 

Students who are failing three or more classes will be ineligible to participate in all extra-curricular activities (practice & play) until the next marking period.

 

Students who receive an incomplete will be required to stay 13th period until the incomplete is made up satisfactorily.

 

A student will be officially ineligible when the list is published and received by the staff.

 

An ineligible student will be restricted to study halls unless he/she has a pre-signed pass from a teacher whose class he/she is failing; or a pre-signed pass from another teacher that has been approved by the Middle School Office.

 

*              Extra-curricular activities are Modified Sports, Ski Club Transportation, Drama Club, Select Chorus, Dances and Plays.


Wayland-Cohocton Central School

Academic Eligibility Policy

High School

 

The academic and/or vocational education of our students is the primary function of our school system.  All activities outside of the classroom require a tremendous amount of time and effort.  These activities are important but will not diminish the educational function of our school.

 

In order to participate in any *extra-curricular activity or to participate in any event outside of regularly scheduled classes, a student must earn and maintain passing grades in his/her academic program of studies.

 

In September of each academic year, all students are eligible to participate in all activities.  At the beginning of each activity, advisors/coaches will submit to the High School Office a roster of students participating in their activity, which will then be compiled into a comprehensive list available to teachers.  Any changes in the rosters must be reported in a timely fashion in order for the comprehensive list to be updated.

 

At each 5-week period, teachers will provide information to the Athletic Office regarding students who are failing any subjects and an academic eligibility list will be generated.  At the end of each 5-week period, students who are failing, receiving an incomplete or and unsatisfactory grade in one class will be allowed to practice and participate if they stay for assistance 13th period.  Students failing, receiving an incomplete or unsatisfactory grade in two classes** will be on probation and will be allowed to practice, providing they stay for assistance 13th period.  However, they will NOT be allowed to participate in any competitions or scrimmages for a minimum of one week.  After one week, it will be a teacher’s prerogative to release a student from the failing list contingent upon a passing grade.  The teacher will notify the coach/advisor, High School Principal, Mr. Whyte and the Athletic Office.  Students must make arrangements with teacher(s) to stay a minimum of two nights per week unless legally excused from school.  Green passes will be used by the staff to communicate practice and participation privileges to the activity supervisor.  If a student does not stay for 13th period assistance, he/she will not be able to practice or participate.

 

If a student receives a failing, incomplete or unsatisfactory grade in three or more classes**, he/she will be ineligible to practice and participate in any activity for a minimum of two weeks.  Students must make arrangements with teacher(s) to stay 13th period at least four nights per week unless legally excused from school.  After two weeks, it will be a teacher’s prerogative to release a student from the ineligibility list contingent upon a passing grade.  The teacher will notify the coach/advisor, High School Principal, Mr. Whyte and the Athletic Office.

 

A student will be officially on probation or ineligible when the failing list is published.

 

An academically ineligible student will be restricted to study halls unless he/she has a pre-signed pass from a teacher whose class he/she is failing, or a pre-signed pass from another teacher that has been approved by the High School Office.

 

*Extra-curricular activities are defined as all non-credit bearing activities in which a student may practice or participate during the school day or after 3:20 pm.  Attendance at school functions will not be monitored for purposes of the academic eligibility list.  (i.e. football games, dances, etc.)

 

**If a student NC’s in a semester course, it will be considered a failing course for the rest of the semester.  If a student NC’s a yearlong course, it will be a failing course for the rest of the year.  In addition, a student may not drop a course they are failing for eligibility purposes. A failing course that is dropped will remain as a failing grade on the eligibility list until the next list is published.

 

Revised 06/15/07

 


 

Parent – Coach Relationship

 

 

Both parenting and coaching are very difficult vocations.  By establishing an understanding of each person’s role, we will be better able to accept the actions of the other and provide great benefits to children participating in Interscholastic Athletics.  When your child(ren) become involved in our sports program, you should have an understanding of what expectations are placed on your child.  This begins with clear communication from the coaches of your child’s program.

 

Communication you may expect from your child’s coach

 

  1. Philosophy of the coach
  2. Expectations that the coach has for your child as well as for the participants on the team
  3. Location and times of all practices and contests
  4. Team requirements (i.e., fees, special equipment, attendance, etc.)
  5. Procedure should your child be injured during a practice/contest
  6. Discipline that may result in the denial of your child’s participation

 

Communications coaches expect from parents

 

  1. Concerns expressed directly to the coach
  2. Notifications of any schedule conflicts well in advance
  3. Specific concerns in regard to coach’s philosophy and/or expectations
  4. Health related issues that may impact child’s ability to participate.

 

As your child becomes involved in programs at Wayland-Cohocton School, they will experience some of the most rewarding moments in their lives.  It is important to understand that there also may be times when things do not necessarily go the way that you or your child may wish.  At these times, discussion with the coach is encouraged.

 

Appropriate concerns to discuss with the coach

 

  1. The treatment of your child mentally and physically
  2. Ways to help your child improve (i.e., attendance at camps, summer leagues, etc.)
  3. Concerns about your child’s behavior

 

It is very difficult to accept your child’s not playing as much as you and your child may hope.  Coaches are professionals.  As such, they make judgment decisions based on what they believe to be the best for all athletes involved as well as the team as a whole.  There are bound to be areas where you as a parent disagree with a coach’s decision.  While the issues above are appropriate to be discussed with the coaches, certain things must be left to the discretion of the coach.


 

Issues NOT appropriate to discuss with coaches

 

  1. Team strategy
  2. Play calling
  3. Amount of playing time
  4. Other student athletes

 

There are situations that may require a conference between the coach and a parent.  These are to be encouraged, since it is important that both parties involved have a clear understanding of the other’s position.  When such a conference is necessary or desired, the following procedure should be followed to help promote a resolution to the issue of concern.

 

Procedure to follow to discuss an issue with a coach

 

  1. Call the coach at Wayland-Cohocton School (728-2366) to discuss the issue with the coach or to arrange an appointment to meet with the coach.
  2. If the coach cannot be reached at school, call the Athletic Director, Mr. Brownell, to arrange an appointment to discuss or meet with the coach.
  3. Do not attempt to confront a coach before, during or after a contest or practice.  These can be emotional times for both the parent and the coach.  Meetings of this nature do not promote resolution of issues.

 

What can a parent do if the meeting with a coach did not provide a resolution?

 

  1. Call the Athletic Director, Mr. Brownell, to discuss the issue and possibly arrange a meeting with the parent, coach and athletic director.
  2. If this step does not provide solution, then a meeting with the secondary principal, athletic director, parent and coach may be arranged.

 

We sincerely hope that this information will assist in making your and your child’s experiences with the Wayland-Cohocton Central School Athletic Department more enjoyable and rewarding!

 

PARENTS MUST SIGN THE ATTACHED SHEET WHICH WILL INDICATE THAT YOU HAVE RECEIVED AND READ THIS COMMUNICATION.  PLEASE RETURN THE SIGNED SHEET TO YOUR CHILD’S COACH WITHIN ONE WEEK OF RECEIPT.

 

ATHLETES MAY NOT BE ALLOWED TO PRACTICE OR PARTICIPATE IF THIS SHEET IS NOT RETURNED TO THEIR COACH BY THAT TIME.

 

THANK YOU!!!


 

 

Dear Parent/Guardian:

 

Wayland-Cohocton High School is about to begin utilizing an innovative program for our student athletes.  The program is called ImPACT (Immediate Post Concussion Assessment and Cognitive Testing).  It is a computerized exam that the athlete takes prior to the season.  If the athlete is believed to have suffered a head injury, they re-take the exam to help determine the extent of the injury, the location of the injury and when the injury has healed.  This system is utilized throughout professional sports, has been mandated in the NHL and is fast becoming the “Gold Standard” in recognizing and better managing concussion type injuries.  The University Of Pittsburgh Medical Center’s Sports Concussion Program is the founding group of this software.  It is used by 18 NFL teams, US Soccer and countless colleges and high schools across the country.  The exam has gained recognition around the world.  Additional information can be found at www.impacttest.com.

 

The exam takes about 15-25 minutes, and is non-invasive.  The program is basically set-up as a “video game” type format.  For example, in one part of the exam, a dozen common words appear at one time on the screen for about one second each.  The athlete is then later asked what words were displayed.  What it is doing is giving the brain a preseason physical of its cognitive abilities.  It tracks information such as memory, reaction time, processing speed and concentration.  It is simple, and actually, most that take it enjoy the challenge of the test. 

 

If a concussion is suspected, the test is re-taken.  If the information can be used to better determine recovery from concussion, it is given to the neuropsychologists at the UPMC to help interpret the data.  The information may be shared with your regular doctor, at your request, and a sound decision can be made as to when return-to-play is appropriate and safe.   At WCCS, we understand the competitive nature of sports, but we always hold the athlete’s health and safety as our top priority.

 

I wish to stress that there is no invasive work being done with this program.  This gives us the best available information in preventing brain damage that can occur with multiple concussions.  The WCCS administration and coaching staffs are trying to keep your child’s health and safety at the forefront of the High School athletic experience.

 

Please sign and return the second sheet indicating permission for your son/daughter to take the test.  If you have any questions regarding this program, please feel free to contact me.  Thank you.

 

Sincerely,

 

 

Jim Brownell, Athletic Director


PERMISSION SLIP

 

For use of the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)

 

I have read and understand the above information.  I have been given an opportunity to ask questions and my questions have been answered to my satisfaction.  I give permission for my son/daughter to participate in the ImPACT Concussion Management Program.

 

 

Printed Name of Athlete                                                              Sport                                    

 

 

Signature of Athlete                                                                    Date                                      

 

 

Signature of Parent                                                                     Date                                      

 

PARENT/GUARDIAN

 

By signing this document, you have given your son/daughter permission to participate in

this sport season and indicates that you understand the Grades 5-12 Extra-Curricular Activities Eligibility Policy, the Academic Eligibility Policy and the Coach – Parent Relationship and the

consequences if violated.

 

Parent/Guardian ______________________________________        Date __________________

 

 

STUDENT/ATHLETE

 

By signing this document, you have agreed to participate in this sport season and that you understand the Grades 5-12 Extra-Curricular Activities Eligibility Policy and the Academic Eligibility Policy and the consequences if violated.

 

Student/Athlete ____________________________________         Date ____________________

 

 

PARENTAL AUTHORIZATION AND WAIVER OF CLAIMS

 

Your child has an opportunity to participate in the Wayland-Cohocton Central School District’s Fitness Room.  Prior to your child’s use of the Fitness Room, you must provide the District with the following:

 

  1. A fully completed Physician’s Medical Clearance form for your child;
  2. An Informed Consent form signed by your child and yourself, as guardian of your child; and
  3. This Parental Authorization and Waiver of Claims form.

 

No student will be allowed to use the District’s Fitness Room if these requirements are not met.

 


STATEMENT OF AUTHORIZATION:

 

As the parent/guardian of ______________________________________, I give consent for my

                                                             (student’s name)

child to use and participate in the activities of the District’s Fitness Room.  In doing so, I state that I understand and agree to the following:

 

  1. In case of a medical emergency, I hereby grant any Fitness Room Supervisor and District employee the right to authorize medical care for my child, if none of the persons named below can be reached.
  2. I have obtained a completed Physician’s Medical Clearance form for my child.
  3. My child has completed the Informed Consent form, which I have acknowledged as parent/guardian of my child, and I agree to the terms and conditions set forth in that Informed Consent form on behalf of my child as his/her parent/guardian.

 

 

ASSUMPTION OF RISK AND WAIVER OF CLAIMS:

 

I acknowledge that potential risks to my child during his/her use of the District’s Fitness Room and participation in its activities, include but are not limited to:  injuries to bones, muscles, tendons and ligaments, dehydration, abnormal blood pressure, fainting and heart disorders (including heart attacks).  As a condition of my child’s use of the District’s Fitness Room and participation in its activities, I assume, on behalf of my child, these and all other risks which may arise from my child’s use of the District’s Fitness room and participation in its activities.  I further waive, release and discharge the Wayland-Cohocton Central School District, its Board of Education, in both their corporate and individual capacities, its employees, agents and assigns, for all claims (of any nature) relating to my child’s use of the District’s Fitness room and participation in its activities, including but not limited to claims for personal injury or death and damage to or loss of personal equipment.

 

 

EMERGENCY CONTACT:

Parent/Guardian:

 

                                                                                                                                               

Name                                                   Home Telephone                       Work Telephone 

Student: 

                                                                                                                                               

Student Signature

                                                                                                                                               

Name of Family Physician                     Street Address                          Telephone

                                                                                                                                               

                                                            City, State and Zip Code

 

 

AUTHORIZATION STATEMENT:

I have read this Parental Authorization and Waiver of Claims form and the Informed Consent form, understand both and have discussed their contents with my child.  Based on the foregoing, I fully and voluntarily agree to the terms and conditions set forth in this form and the Informed Consent form as a condition of my child’s use of the District’s Fitness room and his/her participation in its activities.

 

Date                                                                                                                                        

                                                                        Parent/Guardian Signature