IDFAA-E, Washington Parish School Board Student Athlete Contract

FILE: IDFAA-E

WASHINGTON PARISH SUBSTANCE ABUSE/MISUSE

STUDENT ATHLETE CONTRACT

As a student athlete in the Washington Parish schools, and as an LHSAA athlete, I fully realize the importance of being physically, mentally and morally fit. I vow to avoid the abuse or misuse of legal or illegal substances. I hereby grant permission to be tested for substance abuse/misuse during my tenure as a participant in any LHSAA sports program. I furthermore agree to cooperate by providing a specimen for testing upon request of my principal. I understand that should my specimen indicate the abuse of misuse of legal or illegal substances, I will be subject to action as stated in the Washington Parish School Board Drug Testing and Referral program for Athletes and in The Official handbook of the Louisiana High School Athletic Association.

I understand that to pursue excellence on the playing field I must not experiment with alcohol, illegal drugs or banned substances.

I have received and read, and I am fully aware of and thoroughly understand the Washington Parish School Board Policy Drug Testing and Referral Program for Athletes, which includes (1) a Policy for Random Drug Testing of Washington Parish School Board High School Students Participating in Interscholastic Sports; and (2) Procedures for Random Drug Testing of Washington Parish School Board District Students Participating in Interscholastic Sports, dealing with drug and alcohol use and also the additional rules set forth by the Washington Parish School Board and my school's athletic department.

I understand and realize that there is risk of injury in participating in athletic activities.

I understand that when I participate in any athletic program, I will be subject to random drug testing, and if I refuse, I will not be allowed to practice or participate in any athletic activities. I have read the Washington Parish School Board Authorization/ Consent Form and agree to its terms.

I understand that this is binding while a student is in the Washington Parish School Board school system.

I understand the consequences that I will face should I violate these rules and/or policies, and understand that I am subject to penalties, including loss of athletic participation privileges.

I understand that should I have the need to discuss or seek assistance in reference to a drug or alcohol related matter, it is my responsibility to do this immediately. This can be done with a member of the coaching staff, a school counselor, or administrator. I know that if I ask for help I will receive help. I also understand that this does not relieve my obligation through the mandatory drug testing.

As a Parent/Guardian/Custodian:

I have received and read, and I am fully aware of and thoroughly understand the Washington Parish School Board Drug Testing and Referral Program for Athletes, which includes (1) a Policy for Random Drug Testing of Washington Parish School Board High School Students Participating in Interscholastic Sports; and (2) Procedures for Random Drug Testing of Washington Parish School Board District Students Participating in Interscholastic Sports, dealing with drug and alcohol use and also the additional rules set forth by the Washington Parish School Board and my school's athletic department.

I pledge to promote healthy lifestyles for a student athlete of the School District.

I understand and realize that there is an assumed risk of injury involved for my son/daughter/ward as a participant in athletic activities.

I understand that my son/daughter/ward, when participating in any athletic program, will be subject to random drug testing, and if they refuse, will not be allowed to practice or participate in any athletic activities. I have read the Washington Parish School Board Authorization/Consent Form and agree to its terms.

Student Athlete (sign and print name)

Sign: ____________________________________________

Print: ____________________________________________

Date: ________________________

SS#: _________________ Telephone No.: ________________

Address:___________________________________________

_____________________________________________

Sign: ____________________________________________

Parent/Guardian/Custodian (sign and print name)

Print: _____________________________________________

Date: ____________ Telephone No.: ____________________

Address:____________________________________________

______________________________________________

Sign: ______________________________________________

Parent/Guardian/Custodian (sign and print name)

Print: _______________________________________________

Date: ___________ Telephone No.: _______________________

Address:______________________________________________

________________________________________________

WASHINGTON PARISH SCHOOL BOARD

AUTHORIZATION/CONSENT FORM

Since athletics is an extra curricular activity, the Washington Parish School Board takes added precautions to assure that an athlete will be accorded reasonable safety measures. Athletics is not an essential part of the educational process and thus is not mandated by the Washington Parish School Board. Consequently, the safety procedures required of the athlete are freely embraced by the parents and athletes in view of optimizing the opportunities to minimize injuries to the athlete and to others who participate in sports and otherwise.

The Washington Parish School Board's main purpose of a mandatory drug testing program is not to invade the privacy of the student athlete, but rather its intent is to identify a health or controlled substance dependence which by its very nature would be counterproductive to the safety of the athlete and his/her companions.

These tests will be strictly enforced and participation will be mandatory, since the parent(s)/guardian(s)/custodian(s) have freely chosen to allow their son(s)/daughter(s)/ ward(s) to participate in athletic programs. No athlete will be tested unless at least one parent/guardian/custodian and the athlete sign a form giving permission to have drug testing performed. By signing, the parent(s) and athlete acknowledge that they have consented to the administration of the test and waive any claim of invasion of privacy and waive any objection to the necessary action in the furtherance of these safety proceedings. The undersigned do hereby authorize the Washington Parish School Board to have the tests enumerated herein to be administered as part of its athletic program. Refusal to allow these tests to be administered will immediately serve as notice that the student may not participate in any athletic extra curricular activity.

We do hereby consent to allow the student named in the Student Athlete Contract to undergo drug testing for the presence of illicit drugs or banned substances in accordance with the Washington Parish School Board Drug Testing and Referral Program for Athletes.

We understand that the collection process will be overseen by a qualified Vendor.

We understand that any samples will be sent only to a certified medical laboratory for actual testing, and that the samples will be coded to provide confidentiality.

We do hereby give our consent for testing to the medical Vendor selected by the Washington Parish School Board, their laboratory, doctors, employees, or agents, together with any clinic, hospital, or laboratory designated by the selected medical Vendor. We understand these results will be forwarded to the Superintendent and will also be made available to us.

We understand that consent pursuant to this Informed Consent Agreement will be effective for all athletic sports in which this student athlete might participate during the current school year.

We hereby release the Washington Parish School Board and its employees, designees and agents from any legal responsibility or liability for the release of such information and records, and for any responsibility in connection with the administration of test results, warranties as to accuracy of said tests and medical procedures used by the Vendor and/or referring laboratory.

It is further agreed and understood by the undersigned parent(s)/guardian(s)/ custodian(s) and the athlete that the Washington Parish School Board and its Athletic Department assumes no responsibility for diagnosing or treating any disease that may become known as a result of said laboratory test(s).

If the athlete has been taking medicine, please indicate this prior to the administration of the tests and designate must notify the Principal of the prescribing physician.

Student Athlete (sign and print name)

Sign: _________________________________________________________

Print: _________________________________________________________

Date: ____________________

SS#: ______________________ Telephone No.: ________________________

Address:________________________________________________________

_________________________________________________________

Sign: _________________________________________________________

Parent/Guardian/Custodian (sign and print name)

Print: _________________________________________________________

Date: ________________ Telephone No.: ____________________________

Address:________________________________________________________

_________________________________________________________

Sign: _________________________________________________________

Parent/Guardian/Custodian (sign and print name)

Print: _________________________________________________________

Date: ____________________________________

Telephone No.: ____________________________

Address:________________________________________________________

_________________________________________________________

LHSAA SUBSTANCE ABUSE/MISUSE

CONTRACT AND CONSENT FORM

As an LHSAA athlete, I, agree to avoid the abuse or misuse of legal or illegal substances. I hereby grant permission to be tested for substance abuse/misuse during the 1999-2000 school year as a participant in any LHSAA sports program. I furthermore agree to cooperate by providing a urine or hair specimen for testing upon the request of my principal. I understand that should my specimen indicate the abuse or misuse of legal or illegal substances, I will be subject to action in my School Drug Policy for Student Athletes.

I, parent/guardian of the undersigned student athlete, individually, and on behalf of my child, do hereby grant permission for and consent to said child being tested for substance abuse/misuse in accordance with his/her School Drug Policy for Student Athletes and I understand that if any specimen taken from him/her indicates abuse or misuse of legal or illegal substances he/she will be subject to action specified in the School Drug Policy for Student Athletes for his/her school.

Dated: ______ __________________________________ Student Athlete

Dated: ______ __________________________________ Parent/Guardian

Dated: ______ __________________________________ Principal

Dated: ______ __________________________________ Head Coach

Notes: According to Rule 1.17.2.1, Page B-24 of the 1999-2000 LHSAA By-Laws, without the signature of the student athlete and his/her parent/guardian, the student is ineligible to participate in interscholastic athletic contest at an levels of play in an LHSAA sports at all LHSAA schools until compliance with Rule 1.17.2 is obtained from both parties.

Any student participating in an interscholastic athletic contest(s) without a properly signed contract shall be classified as an ineligible student and both the student and school will be penalized according to the LHSAA Penalty Code.

Signature of the LHSAA's contract does not necessarily mean that the student athlete will be tested.

Federal courts have consistently ruled participation in high school athletics is a privilege, not an educational right.

CONFIDENTIALITY STATEMENT FOR RANDOM DRUG

TESTING PROGRAM

I, acknowledge that I will be privilege to hear and see sensitive information related to results of random drug testing performed on student athletes of Washington Parish School Board Schools. I pledge to keep any information given to me in strict confidence, and will only release this information to others as dictated by The Board Policy or with properly obtained permission of the student and a parent/guardian/custodian.

________________________

Signature

________________________

Position

Washington Parish School Board