It is understood that C.S. Lewis Academy is not liable for any medical, dental, or hospital bills occurring as a result of athletic injuries by a student while participating in a supervised sport, and that such bills, in excess of insurance benefits, shall be the responsibility of the student-athlete's parents/guardians.
Participants in the CSLA Sports Program who are not daily students at CSLA (Home School) are required to submit a front and back copy of a valid medical insurance card covering your son/daughter and a completed CSLA emergency contact form. .
I further recognize that medical treatment on an emergency basis may be necessary at a time when I am not available to give my consent in advance of such emergency care, and I give permission to the school to authorize such care as may be deemed necessary under existing circumstances. Consent is also given for an emergency referral to an appropriate physician if, in the opinion of appropriate coaches and representatives of the school, further evaluation is needed.
I hereby give permission for records for my son/daughter of any diagnosis, diagnostic testing, and/or treatment be released to C.S. Lewis Academy and/or its insurance carrier, in order for them to be better informed of his/her medical condition and capabilities while participating in athletics for C.S. Lewis Academy. I understand that the disclosure of protected health information will only be used for the purpose of providing treatment or to conduct healthcare operations of either C.S. Lewis Academy or an emergency care facility.
I acknowledge that participation in the sport or sports described above involves risk to the Participant (and to the Participant’s parents or guardians, if the Participant is a minor), and may result in various types of injury including, but not limited to, the following: sickness, bodily injury, death, emotional injury, personal injury, property damage and financial damage.
In consideration for the opportunity to participate in the sport or sports described above, the Participant (or parent/guardian if Participant is a minor) acknowledges and accepts the risks of injury associated with participation in and transportation to and from the Activity. The Participant (or parent/guardian) accepts personal financial responsibility for any injury or other loss sustained during the sport or sports or during transportation to and from the sport or sports, as well as for any medical treatment rendered to the Participant that is authorized by C.S. Lewis Academy or its agents, employees, volunteers, or any other representatives.
Further, the Participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless C.S. Lewis Academy or its agents, employees, volunteers, or any other representatives, for any injury arising directly or indirectly out of the described sport or sports or transportation to and from the Activity, whether such injury arises out of the negligence of the Activity Sponsor, the Participant, or otherwise.
If a dispute over this agreement or any claim for damages arises, the Participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable alternative dispute resolution process. If the Participant (or parent/guardian) and C.S. Lewis Academy cannot agree upon such a process, the dispute will be submitted to a three-member arbitration panel for resolution pursuant to the rules of the American Arbitration Association.
Grade School: 3-5th Soccer/3-4th Basketball: $40Grade School Volleyball 4-6th/Basketball 4-6th/Track & Field 5th: $806th Graders playing both 4-6th and MS volleyball pay $100
Middle School Soccer, Volleyball, Basketball, Track & Field: $1306th Graders playing both 4-6th and MS basketball pay $100
High School Soccer, Volleyball, Basketball, Track & Field, Golf: $180
Payment can be made by check sent to the FINANCE OFFICE, or online. Payment by credit card does require a small convenience fee.
Any practice or game uniforms or equipment issued to a student-athlete is the responsibility of that student-athlete. Students will be held monetarily accountable and replacement charges added to the student's financial account for unreturned uniforms or equipment.
The State Board of Education adopts by reference the form entitled "School Sports Pre‐Participation Examination May 2017" that must be used to document the physical examination and sets out the protocol for conducting the physical examination. Medical providers conducting physicals on or after June 30, 2010 must use the form dated May 2017.
Stat. Auth: ORS 326‐051<br>Stats. Implemented: ORS 336.479<br>Hist.: ODE 24‐2002, f. & cert. ef. 11‐15‐02; ODE 29‐2004(Temp), f. & cert. ef. 9‐15‐04 thru 2‐25‐05; ODE 4‐2005, f. & cert. ef. 2‐14‐05
If the student-athlete has NOT completed a per-participation physical, they CANNOT participate in practices or contests until the physical is completed, cleared, and submitted to the athletic office.
Link to Physical Examination Form:http://www.osaa.org/docs/forms/PhysicalExamination-English2017.pdf
When teams travel for games/practices away from the C.S. Lewis campus, transportation may be furnished by the school. When school transportation is provided, student-athletes must travel both to and from the location of the contest by school-provided transportation unless exceptions are granted by an official coach of that team, the director of athletics, or a CSLA administrator.
For many activities CSLA will not be providing transportation to and from the event. For those events/activities, CSLA has a private transportation policy. Every family must complete the Private Transportation Release form yearly. That information, including a family's desire to transport independently, will be used for athletics event transportation purposes.
Eligibility Student Transfer Certificate (for 10th-12th grade students transferring in to CSLA from another school at the beginning of the school year or 9th-12th grade students transferring in to CSLA after the school year has started) The Eligible Student Transfer Certificate form linked below must be turned in.
Foreign Student Transfer Certificate -any exchange student wishing to participate for CSLA athletics needs to download and review the Foreign Student Eligibility Certificate linked below.
Eligibility Student Transfer Certificatehttp://www.osaa.org/docs/forms/EligibleStudentTransferCertificate.pdf
Foreign Student Transfer Certificatehttp://www.osaa.org/docs/forms/ForeignStudentEligibilityChecklist.pdf
Since we are under the governance of the Oregon School Activities Association (OSAA) the requirements are somewhat extensive.
Please note that our association with the Metro Christian League prevents us from allowing home school students to participate at the grade school or middle school levels.
1. For your student-athlete to be considered a “home school” student, you MUST meet all criteria as outlined on the OSAA Parents Checklist (see below).
2. A student who is enrolled full time at another OSAA member or associate member school (recent suggestions have been Estacada Charter and Connections Academy), would not qualify as a home school student and would not be allowed the athletics eligibility provisions of a home school student. In most of these cases the student may be allowed to participate in athletics at his/her local public school, but not CSLA.
The OSAA has emphasized that as a home school parent, you must be diligent in following Oregon State law. You can find the pertinent State laws and statutes linked from the ESD site. (see below)
Home School Student-Athlete Additional Requirement List
1. One time only, you will need to complete the OSAA School Representation Eligibility Certificate.(see below)
2. Initialed and signed copy of the OSAA Checklist (yearly-see below)
3. Letter of confirmation from ESD. Link to Willamette ESD, serving Yamhill County. (one-time-see below)
4. Copy of the test results noted on checklist showing a proficiency which meets OSAA criteria. (submitted yearly)
5. Copy of a current Insurance Card submitted to the Director of Athletics
OSAA School Representation Eligibility Certificatehttp://www.osaa.org/docs/forms/SchoolRepresentationEligibilityCertificate.pdf
OSAA Home School Checklisthttp://www.osaa.org/docs/forms/HomeSchoolEligibilityParentChecklist.pdf
Willamette Valley ESDhttps://www.wesd.org/homeschool
A. “Member Private School’s Responsibilities (Max's Law, ORS 336.485, OAR 581-022-0421) (Jenna’s Law, ORS 417.875)
1) Suspected or Diagnosed Concussion: Any athlete who exhibits signs, symptoms or behaviors consistent with a concussion following an observed or suspected blow to the head or body, or who has been diagnosed with a concussion, shall not be permitted to return to that athletic contest or practice, or any other athletic contest or practice on that same day. In schools which have the service of an athletic trainer registered by the Oregon Board of Athletic Trainers, that athletic trainer may determine that an athlete has not exhibited signs, symptoms or behaviors consistent with a concussion, and has not suffered a concussion, and return the athlete to play. Athletic trainers may also work in consultation with an appropriate Heath Care Professional (see below) in determining when an athlete is able to return to play following a concussion.
2) Return to Participation: Until an athlete who has suffered a concussion is no longer experiencing signs, symptoms, or behaviors consistent with a concussion, and a medical release form signed by an appropriate Health Care Professional (Physician (MD), Physician’s Assistant (PA), Doctor of Osteopathic (DO) licensed by the Oregon State Board of Medicine, nurse practitioner licensed by the Oregon State Board of Nursing, or Psychologist licensed by the Oregon Board of Psychologist Examiners) is obtained,the athlete shall not be permitted to return to athletic activity.
3) Private Schools Only: On an annual basis prior to participation, private schools shall require each student and at least one parent or legal guardian of the student to sign the Concussion -Private School Informed Consent form acknowledging the receipt of information regarding symptoms and warning signs of concussions. Private schools shall maintain a copy of each student's signed form on file for review at any time by the OSAA staff.
See OSAA Executive Board Policies, “Concussion Management” for additional information.
In addition, the OSAA has collected several documents outlining the most recent information about diagnosis and returning from concussions: Please take time to review this information.
The links below give you, as a parent, some immediate information on the symptoms and warning signs of concussions.
OSAA~ Parent Guide to Concussionhttp://www.osaa.org/docs/health-safety/ParentGuidetoConcussionApril2013.pdf
OSAA~ Health/Safety- Concussionshttp://www.osaa.org/health-safety/concussion
1. I have been provided with information on concussions in high school sports in compliance with ORS 417.875.
2. I understand that on an annual basis, the Concussion – Private School Informed Consent form shall be signed and turned into my school’s Athletic Director by myself (or my parent or legal guardian if I am under the age of 18 years old) prior to my participation in a practice or competition.
However, should your student-athlete decide at a later date to add a sport not indicated here, the Athletics Director will need a note/email stating your desire to add that sport to this form.
See you on the field/court!