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High School Marching Band 2019

Payment Deadline 08/16/2019

Welcome Band Members & Parents,

The PIAA Physical packet (Comprehensive Initial Pre-Participation Physical Evaluation or CIPPE) has been updated for the current school year. To be eligible to participate in the Peters Township Marching Band a physical evaluation must be completed within 12 months of the current start date.  Section 5 (Health History) is to be completed by parent and Section 6 (Physical) is to be completed and signed by a physician and both forms are to be uploaded into Family ID.

The following forms must be completed on-line: School District Forms: Code of Conduct / Sportsmanship (Form A), Waiver, Release, and Informed Consent (Form B), Awareness Form (Form C), Concussion Management Awareness Form.
Additional information about concussions can be found at http://www.ptsd.k12.pa.us/ConcussionInformation.aspx.

ACTIVITY FEES:
Please return the athletic fee with the form attached. High School fees should be sent to the Marching Band Director. 

Locations
Sections
Participant Information
Agreements

For each of the agreements below, please read the terms, check the box to mark your acknowledgement, and type your name to confirm.

Sportsmanship Code of Conduct and Guidelines Agreement

Sportsmanship Code of Conduct – YES Program

This season, as a player, coach, parent, or spectator, I pledge to COMPETE with Class and Honor:

  • I will abide by the rules of the game.
  • I will offer encouragement, not criticism, to players and coaches.
  • I will accept judgment calls of game officials.
  • I will show respect for the efforts of both teams.
  • I will accept the outcome of the contest, either winning or losing, properly and respectfully.
  • I will acknowledge that all members of the team – parents, coaches, and players – share equally in the responsibility to promote good sportsmanship.

As a member of an athletic activity in the Peters Township School District, you should be fully aware that participation in the athletic programs is a privilege and a responsibility not a right. Athletes earn recognition for their achievements as representatives of their team and the community. When athletes accept this privilege, they must live up to the Code of Conduct.

  • Students participating in extracurricular activities are expected to refrain from using or having possession of alcohol or any other illicit drug including off campus/non school related activities.
  • Students participating in athletic activities are expected to refrain from using or having possession of tobacco in any form in school, on school grounds, during practice, events, or at any other time while a student at Peters Township.
  • Students participating in athletics are prohibited from organizing, soliciting, aiding or participating in any type of hazing for any class, school-sponsored club, activity, or athletic team. Hazing is any intentional, knowing, or reckless act directed against a student for the purpose of being initiated into, affiliation with, holding office or maintaining membership in any class, school-sponsored club, activity, or athletic team.
  • Students participating in athletics are expected to follow all team rules, regulations, and guidelines established by the coaching staff and athletic department.
  • Students participating in athletics are expected to Honor the Game by respecting the rules, opponents, officials, teammates, and self.
  • Students participating in athletics are expected to meet the academic eligibility requirements established by the PIAA.

The Indian Pride Sportsmanship Guidelines

Acceptable Behavior

  • Know the rules and strategies of the contest in order to cheer at proper times.
  • Maintain enthusiasm and composure, serving as a role model.
  • Participate positively in the event or contest by supporting the coaches and participants.
  • Exercise good judgment in cheering for outstanding performance, not against opponents or to ridicule an error. It is certainly acceptable to applaud on outstanding performance by an opponent and to applaud all participants at the end of the contest.
  • Follow the cheerleaders in positive cheers and yells to show support for the participants..
  • Be an exemplary role model by positively supporting teams in every manner possible, including content of cheers and signs.
  • Show respect and concern for an injured player, regardless of team.
  • Respect decisions made by contest officials.
  • Realize that a ticket represents a privilege and a responsibility to observe and positively support a high school activity, not a license to verbally assault others or be generally obnoxious.
  • Respect fans, coaches, and participants.
  • Encourage surrounding fans to display only sportsmanlike conduct.
  • Resist being drawn into negative conduct by other fans, including opposing fans.

Unacceptable Behavior

The following have been defined as negative and unacceptable by PIAA, VVPIAL, South Hills Principals Association, and Peters Township High School.

  • Disrespectful or derogatory yells, chants, songs, or gestures.
  • Booing or heckling an official's decision, criticizing officials in any way, displays of temper with an official's call.
  • Yells that antagonize opponents.
  • Blaming loss of game on officials, coaches or participants.
  • Doing own yells instead of following lead of cheerleaders.
  • Yelling at or criticizing coaches or participants of either team.
  • Attempting to coach from the bleachers or sidelines, giving specific instructions to any participant.
  • Destruction of property, signs, or equipment.
  • Running onto the floor or field of play before, during, or after the contest.
  • Engaging an opposing fan in a dispute or argument.
  • Use of profane, vulgar, or abusive language

The school administration is responsible for enforcement of all activities, including those at other facilities. Any person acting in an unacceptable manner faces expulsion from the contest or activity and possible exclusion from subsequent contests or activities.

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I have in my possession, have read, and am aware of the rules and regulations that govern the conduct of the student who is a participant in the current season sport.

I agree to abide by and support the Code of Student Conduct, the rules established by the coach or sponsor of this sport/activity, the Student‑Parent Handbook and the policies set forth by the Peters Township School Board. If I choose to disobey, I understand the consequences and agree to accept them.

NOTE: It is expected that each coach/sponsor shall meet with participants prior to the start of the activity or sport and at this time fully explain the Code of Student Conduct. All participants and parents will be expected to sign the awareness form online and prior to the beginning session of the sport or activity.

FAILURE OF COMPLIANCE WITH THIS PROCEDURE SHALL PRECLUDE PARTICIPATION

OF THE STUDENT IN THE SPORT OR ACTIVITY THERE SHALL BE NO EXCEPTIONS.

Preventing MRSA and Duty to Warn Agreement

Preventing MRSA

What Every Parent Should Know

WHAT IS MRSA?
Methicillin-resistant staphylococcus aureus (MRSA) infection is caused by staphylococcus aureus bacteria — often called "staph." Staph bacteria are generally harmless unless they enter the body through a cut or other wound, and even then they often cause only minor skin problems in healthy people. In the 1990s, a type of MRSA began showing up in the wider community. Today, that form of staph, known as community-associated MRSA, or CA-MRSA, is responsible for many serious skin and soft tissue infections and for a serious form of pneumonia.

WHAT ARE THE SYMPTOMS OF MRSA?
In the community, most MRSA infections are minor skin infections that may appear as sores or boils that are often red, swollen, painful, or have pus or other drainage. These skin infections commonly occur either at sites of breaks in the skin such as cuts and abrasions, and areas of the body covered by hair (for example, the back of the neck, groin, buttock, armpit, or beard area of men).


MRSA and other staph skin infections begin with classic signs of infection: a red, swollen, and painful area on the skin that is often warm to the touch. As the infection becomes more serious, symptoms can include: a skin abscess, drainage of pus or other fluids from the site, fever, chills, rash, fatigue, muscle aches, and headache.

HOW IS MRSA SPREAD?
Like other causes of skin infections, MRSA is usually spread from person to person through direct skin contact or contact with shared items or surfaces (i.e. towels, used bandages, or weight training equipment surfaces) that have touched a person's infection.

SIMPLE MEASURES TO PREVENT OR MINIMIZE THE RISK OF MRSA

Wash hands frequently and thoroughly throughout the day with soap and warm water or use an alcohol-based hand sanitizer

Wash hands before leaving the restroom

Shower after all athletic competition

Use liquid soap, not bar soap

Refrain from cosmetic (whole body) shaving

Avoid sharing items such as towels, razors, equipment, soap, etc.

Shower before using whirlpools or cold tubs

If you have any open wounds, sore, scratches, or scrapes avoid whirlpools,
hydrotherapy pools, cold tubs, swimming pools and other common tubs

Clean and properly cover open wounds, abrasions, lacerations, etc. at all times

Do not ignore skin infections, pimples, pustules, abscesses, etc. Report these to a school nurse, sports medicine staff member and/or physician immediately

Have all suspicious lesions evaluated before practice or competition

Wash all work-out gear after practice or competition

Do not share water bottles

How do I treat a MRSA infection?

As with any bacterial infection:

Consult your doctor

Tell your doctor if you are an athlete

Take all antibiotics as prescribed by your doctor, even if the infection seems to have healed

Inform your doctor, trainer and parent if the wound is not improving

Keep the wound covered at all times until completely healed

Bring a doctor's note to the trainer indicating your diagnosis and treatment plan

MRSA in Athletics

Skin infections occasionally become a problem in all sports, with participation in some activities more prone for exposure to infections than others. Peters Township School District follows a detailed cleaning schedule and uses the recommended guidelines from the National Federation of State High School Associations to: (1) help identify an outbreak, (2) means to minimize its spread and (3) preventative measures to reduce its occurrence.

If a case of MRSA is identified in a Peters Township athlete, there are ways to help reduce its spread:

When you or someone you know has any of the signs of MRSA, immediately report it to your coaches, trainers, and parents or guardians. The athlete will then be held out of all practices and competitions until a medical diagnosis and clearance is obtained.

If an athlete with a suspect skin condition is cleared for participation, they must cover the affected area(s) with a water resistant dressing, or gauze pad with water resistant covering on at least one side, until the lesion(s) is completely gone.

If the lesion(s) is on an athlete's face or neck, they should launder their pillow case on a daily basis.

Athletes with any signs of a communicable skin condition should wash their hands frequently to avoid contaminating themselves, or others. Athletes with communicable skin conditions must be made aware that contact they have with others during the school day, outside of their sport's practices or competitions, may spread the condition to others.

What has PTSD done to protect my child from MRSA?

The Peters Township School District takes a proactive approach to protect students throughout the District. this informational brochure is made available to the staff, students, and parents in all nurses' offices, the athletic office, and in the main office of each building. In addition, MRSA prevention and instructions on what to do if a case is suspected are supplied in the student handbook for each building. Throughout the District, regular cleaning schedules have been outlined and procedures are reviewed regularly with the custodial and buildings and grounds staff.

Any skin irritation should be reported to the school nurse to evaluate the irritation and document the findings. Parents/Guardians will be notified and a course of further action will be identified.

The Peters Township School District reminds parents and students to:

Keep your hands clean by washing thoroughly with soap and water or using an alcohol-based hand sanitizer.

Keep cuts and scrapes clean and covered with a bandage until healed.

Avoid contact with other people's wounds or bandages.

Avoid sharing personal items such as towels, razors, sports equipment or soap.

References

Allegheny County Health Department; Cancer Research UK; Center for Disease Control (CDC); National Federation of State High School Associations (NFHS); Pennsylvania State Interscholastic Athletic Association (PIAA); Western Pennsylvania Interscholastic Athletic League (WPIAL)

DUTY TO WARN

There are many benefits of athletic participation in the mental, physical, and emotional development of the student/athlete, but there is also the possibility that an athlete may be injured. Courts have held that school districts have a duty to warn participants of the risks involved. This statement is made to carry out that duty. Listed below are the risks of athletic participation.

CATASTROPHIC RISKS OF ATHLETIC PARTICIPATION

1. Death: from trauma or inherent physical weakness

2. Paralysis: spinal injury; broken back

OTHER RISKS OF ATHLETIC PARTICIPATION (NOT ALL INCLUSIVE)

3. Wounds cuts; blisters; fat lip

4. Sprains twisted knee; torn ligaments, jammed fingers

5. Strains pulled muscles; charlie horse

6. Dislocation

7. Fracture broken bones (arms, legs)

8. Inflammation infection

9. Concussion knocked out; brain damage

10. Heat exhaustion

11. Miscellaneous fingers in eye; bruises

We realize that there is a risk of said athlete being injured that is inherent in all sports.

We realize that the risk of injury may be severe including, but not limited to those listed above.

Waiver, Release, and Informed Consent

It is the policy of the Board of School Directors of the Peters Township School District to offer all students the opportunity to participate in interscholastic athletics and other extracurricular

Activities. I acknowledge that the aforesaid policy of the Board of School Directors does not

constitute an undertaking by the School District to assume any medical or related expenses which may occur as a consequence of student participation in such activities. I also acknowledge that there is no obligation on the part of the school district to provide medical or hospitalization insurance.

I acknowledge that injuries to the student may occur as injuries are inherent to any physical activity. I understand that as a parent or legal guardian of the student desiring to participate in the above activity, I shall retain responsibility for medical care and related expenses and for medical and hospitalization insurance.

I agree to present to the School District a certificate indicating that I have secured medical and hospitalization insurance for the student. I also acknowledge that I can obtain through the School District Risk Manager upon proper application and upon payment of the appropriate premium the following insurance:

1. Mutual of Omaha Student Accident Plan (Does not cover high school varsity football)

2. Mutual of Omaha High School Football Accident Insurance

YOU ARE CAUTIONED TO SEE THE BROCHURES AND MASTER POLICIES FOR COMPLETE DETAILS CONCERNING SUCH POLICIES.

I further agree to indemnify and hold harmless the Peters Township School District, its employees and agents, from any expense that may be incurred in connection with the participation of my son

or daughter (above named) in the activity listed above.

Intended to be legally bound, I do hereby release, discharge, and waive the Peters Township School District, its employees and agents, from any liability for any injury to my son or daughter (above named) resulting from any cause whatsoever in connection with the activity listed above except as provided in the Judicial Code, 42 PA. C.S.A. Section 8541 et seq. I (i.e. operation of motor vehicles and ownership and control of real and personal property, etc.).

For additional information regarding insurance coverage please refer to the School District website www.ptsd.k12.pa.us


Code of Student Conduct

I have in my possession, have read, and am aware of the rules and regulations that govern the conduct of the student who is a participant in the current season sport.

I agree to abide by and support the Code of Student Conduct, the rules established by the coach or sponsor of this sport/activity, the Student‑Parent Handbook and the policies set forth by the Peters Township School Board. If I choose to disobey, I understand the consequences and agree to accept them.

NOTE: It is expected that each coach/sponsor shall meet with participants prior to the start of the activity or sport and at this time fully explain the Code of Student Conduct. All participants and parents will be expected to sign the awareness form online and prior to the beginning session of the sport or activity.

FAILURE OF COMPLIANCE WITH THIS PROCEDURE SHALL PRECLUDE PARTICIPATION

OF THE STUDENT IN THE SPORT OR ACTIVITY THERE SHALL BE NO EXCEPTIONS.

Please make a selection *
Authorization for Release of Protected Health Information

Allegheny Health Network

Authorization for Release of Protected Health Information

  • I hereby authorize the Allegheny Health Network – Sports Medicine licensed athletic trainer(s) and team physician(s) to release my Protected Health Information (PHI):
  • The following would have access to the Protected Health Information: School Administration, Secretaries, Nurses and Coaches, and the child's parents.
  • I understand that this Authorization shall expire one (1) year from the date of signature unless otherwise specified below.
  • I understand that I may revoke this Authorization at any time by mailing or personally delivering a signed, written notice of revocation to the healthcare provider at which this Authorization was executed. Such revocation will be effective upon receipt, except to the extent that the recipient has already taken action in reliance on this Authorization.
  • I understand that, to extent that any recipient of this information, as identified above, is not a "covered entity" under Federal Law, the information may no longer be protected by federal and state law. I understand that, in these circumstances, the individual receiving this information may be permitted to re-disclose the information. I understand that my healthcare provider is not responsible should the individual receiving this information re-disclose the information.
  • I am entitled to a copy of this completed Authorization upon my request.
  • I hereby acknowledge that I have read and fully understand the above statements as they apply to me.

Authorization for Consent of Treatment, by Licensed Athletic Trainer(s)/Team Physicians, Within the Scope of Practice

As parent, legally authorized representative, or athlete if over 18) I hereby authorize West Penn Allegheny Health System, Inc. – Allegheny General Hospital (AGH)Certified Athletic Trainer(s)/Team Physicians to provide only those services they are qualified through education or experience and which is allowed by their practice acts and other pertinent regulation.

This authorization is valid for 1 calendar year from the date below.

I understand that this authorization is subject to revocation at any time, except to the extent that West Penn Allegheny Health System, Inc. – Allegheny General Hospital has already taken action in reliance upon it. A photocopy or facsimile of this authorization will be considered valid unless otherwise specified. I also understand and agree that this authorization will terminate as set forth above unless I revoke this authorization in writing to AGH (1307 Federal Street, Suite 500, Pittsburgh, PA 15212).

Concussion Management Program Awareness

PETERS TOWNSHIP SCHOOL DISTRICT

CONCUSSION MANAGEMENT PROGRAM

AWARENESS FORM

As required in Peters Township School District Policy # 5143 AR-1, the Peters Township Athletic Department will offer parents and student athletes information on Concussion Baseline Testing, updated knowledge about concussions as a mild traumatic brain injury (TBI), treatment, management, and common signs and symptoms of a concussion. All parents, coaches, and student athletes are strongly encouraged to read all of this information.

Annually, prior to trying out for a sport, all parents and student athletes will be required to participate in and document having successfully completed one of the following, in order for the athlete to practice or play:

Please sign after successfully completing one of the following:

OPTION A - Review all information pertaining to concussions provided by the School District (Information will be posted on the website and will include video of the preseason informational concussion meetings.)

OPTION B - Take an approved educational course on concussions (Course options can be found on the district website).

Payment Method
Athletic Check or Money Order (NO CASH)

All HS athletes should submit check or money order (no cash) along with the payment fee form to the Athletic Office at the high school.

The MS athletes should submit check or money order (no cash) along with the payment fee form to the coach or to the Athletic Office at the high school.

Make checks or money order to Peters Township School District.

Refund Instructions
Circumstances Eligible for Reimbursement: Any athlete who sustains a documented (applicable doctor’s note) season-ending injury within the first seven days of the first WPIAL recognized game, and the athlete decides to not stay with the team within those seven days, he/she is eligible to have their fee reimbursed by the District. After the try-out period, any athlete who is not selected will be eligible for reimbursement upon request. Fee reimbursements will not be issued if a student quits a team for reasons other than specified above.