GREENE PARENT/STUDENT-ATHLETE PLEDGE FORM

Student :

print) Grade:

Attendance: A student-athlete must attend school the whole day or be legally excused for reasons other than illness to be eligible to participate in a practice or contest on that day. Students participating in activities during the school week are expected to attend school the whole day following the activity in question in order to be eligible to practice the following day.

Sportsmanship: We have received (online), read and understand the MAC Sportsmanship Policy. We agree to abide by it and exhibit appropriate sportsmanship at all times.

Training Rules: I have received a copy of the training rules and agree to be tobacco, alcohol and drug free. As an athlete, I agree to abide by all rules regarding the use of drugs. I understand that drug addiction is a disease and, even though it may be treatable, it has serious physical and emotional effects – effects that would hurt me, my family, my team and my school. Given the serious dangers of drug use, I accept and pledge to follow all rules established by my school, team, and community regarding the use of drugs. Athletic Injury Warning Statement: Participation by a student in athletic activities involves some degree of risk of physical injury or exposure to the coronavirus. Such physical injury can occur in any type of sport activity, be it a collision, contact, or non-contact sport. Furthermore, many injuries are truly accidental in nature and involve no negligence by anyone, including a student. By voluntarily participating in a school sponsored athletic activity, a student and his/her parent(s) assume the risk for injuries that occur. Greene CSD contracts with Lourdes Sports Medicine personnel, who work in collaboration with the school’s medical director and school nurses, to care for and treat sport related injuries/illness.

Insurance Coverage: We understand that the parent’s insurance provides primary coverage and secondary coverage is provided by Greene CSD. The district’s policy is in place to cover the remaining costs not covered by primary insurance.

Concussion Fact Sheet: We acknowledge receipt (online) of the Heads Up Concussion in High School Sports Parent Fact Sheet located in the Parent/Student – Athlete Handbook. The New York State Education Department requires each school district to have a concussion management policy. The Greene CSD Concussion Management Policy is located in the Parent/Student – Athlete Handbook. We understand that student athletes diagnosed with a concussion must complete a Return to Play protocol once cleared by a physician.

Sudden Cardiac Arrest Act: The Dominic Murray Sudden Cardiac Arrest Prevention Act is a new law as of July 1, 2022. This law requires schools, students, and parents/guardians have information on sudden cardiac arrest risks, signs, and symptoms. Please note that sudden cardiac arrest in children and youth is rare. The incidence of sudden cardiac death (SCD) on the playing 100,000.1 field is 0.61 in Sudden Cardiac Arrest (SCA) is an emergency that happens when the heart suddenly stops working. SCA can cause death if not treated immediately, and even with treatment death may occur. Immediate treatment is cardiopulmonary resuscitation (CPR) and use of an automatic external defibrillator (AED). All public schools must have a staff member trained in the use of CPR and AED in school and at all school athletic events.