2018-2019 Athletic Registration Form
Please fill out the following form with the necessary information. After the various documents type the parent/guardian's name.
This will serve as official sign-ups and satisfy the necessary state and district paperwork requirements. If you have any questions please contact Kevin Caruso at kcaruso@maynard.k12.ma.us.
Student's LAST NAME *
Your answer
Student's FIRST NAME *
Your answer
Parent/Gaurdian Email Address *
Your answer
Fall Season 2018
Winter Season 2018-2019
Spring Season 2019
What Grade will your child be for the 18-19yr? *
Parent-Consent Form *
We the undersigned father and mother or guardian(s) of: A minor, do hereby consent to his/her participation in voluntary athletic programs and do forever RELEASE, acquit discharge and covenant to hold harmless the Town of Maynard, a municipal corporation of the State of Massachusetts, and its successors, departments, officers, employers, servants and agents of and from any and all actions, causes of actions, claims, demands, damages, costs, loss of services, expenses and compensation on account of, or in any way growing out of, directly or indirectly, all known and unknown personal injuries and property damages which we/ I may now or hereafter have as parent(s) or guardian(s) of said minor, and also all claims or right of action from damages which said minor has or hereafter ay acquire, either before or after he/she has reached his/her majority resulting or to result from his/her participation in the Maynard Public Schools Physical Education Department’s athletic programs: FURTHERMORE, we/I hereby agree to protect the Town of Maynard and its successors, departments, officers, employees, servants and agents, against any claims for damages, compensation or otherwise on the part of the said minor growing out of or resulting from injury to said minor in connection with his/her participation in the Maynard Public Schools Physical Education Department’s voluntary athletic programs, and to IDEMNIFY, reimburse or make good to the Town of Maynard and its successors, departments, officers, employees, servants and agents any loss or damages or costs, including attorney’s fees, the Town or its representatives may have to pay if any litigation arises from said minor’s intentional, grossly negligent, or reckless acts or omissions while participating in said sports programs.
Your answer
Chemical Health *
This agreement between students, their parents or guardians, and Maynard Public Schools is designed to serve several purposes. It is intended to influence students to make wise and legally sound decisions. It is also designed: • To help ensure the physical and mental health of students; • To enable student athletes and leaders to set an example of responsible behavior; • To promote zero-tolerance of under age (21 years) drinking as defined by federal and state laws, as well as of the use of illegal and harmful chemical substances among our youth; • To bind the community together in support of its students; This agreement was first developed by the Massachusetts Interscholastic Athletic Association (MIAA), and was created in pursuant to the rules of the MIAA. Our high school membership in this association allows our athletic teams to compete in the Mid-Wach League. To maintain membership, we must adhere to and enforce the MIAA policy. RULE During the season of practice or play, a student shall not, regardless of the quantity, use, consume, possess, buy/sell, or give away any beverage containing alcohol; any tobacco product; marijuana; steroids; or any controlled substance. As defined under, Mass General Laws, Ch 90D. This policy includes products such as “NA or near beer”. Or intake the vapors of any intoxicating substance, such as glue, nitrous oxide and the like, sometimes referred to as “huffing”. It should be noted that: If a student in violation of this rule is unable to participate in interscholastic sports due to injury or academics, the penalty will not take effect until that student is able to participate again. The rule is in effect from the earliest fall practice date to the conclusion of the academic year or final athletic event (whichever is latest). • 1st Offense: When the Principal confirms, following an opportunity for the student to be heard, that a violation occurred, the student shall lose eligibility for a minimum of 25% of the season or next season of participation. Penalties carry to the following season. If the student is unable to participate due to injury, academics or otherwise, the penalty will not take effect until that student is able to participate again. • 2nd offense and subsequent offense: The student will lose eligibility for a minimum of 60% of the season or next season of participation. The student must also attend at least three approved substance abuse sessions. • In either instance, further disciplinary action may be taken by the school, including informing legal authorities or mandating drug and alcohol counseling. • Also be reminded of the Principal’s Authority to Suspend and/or Expel Under the terms of the Education Reform Act and MGL, Section 37 H, the principal of a school containing grades nine through twelve has the authority to immediately suspend and/or expel a student under the following conditions: found on school premises or at school sponsored or school related events, including athletic games, in possession of a dangerous weapon, including but not limited to a gun or a knife; or possession of a controlled substance as defined in MGL 94 C
Your answer
Concussion/Hazing *
CONCUSSION INFORMATION: STATE LAW REGARDING SPORTSRELATED HEAD INJURY & CONCUSSIONS The Commonwealth of Massachusetts Executive Office of Health and Human Services now requires that all schools subject to the Massachusetts Interscholastic Athletic Association (MIAA) rules adhere to the following law. Student-athletes and their parents, coaches, athletic directors, school nurses and physicians must learn about the consequences of head injuries and concussions through training programs and written materials. The law requires that athletes and their parents inform their coaches about prior head injuries at the beginning of the season. If a student-athlete becomes unconscious during a game or practice, the law now mandates taking the student out of play or practice, and requires written certification from a licensed medical professional for “return to play.” Parents and students who plan to participate in any athletic program offered by the Maynard Public Schools must also take a free on-line course. Two free on-line courses are available and contain all the information required by law. The first is available through the National Federation of High Schools. The entire course takes approximately 30 minutes to complete. http://www.nfhslearn.com/electiveDetail.aspx?courseID=15000 The second on-line course is available through the Centers for Disease Control and Prevention at: www.cdc.gov/Concussion HAZING INFORMATION: Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows: Chapter 269 of the General Laws is hereby amended by adding the following three sections: Section 17: Whoever is a principle organizer or participant in the crime of hazing as defined herein shall be punished by a fine of not more than one thousand dollars or by imprisonment in a house of correction for not more than one hundred days, or by both such fine and imprisonment. The term "hazing" as used in this section and in sections eighteen and nineteen, shall mean any conduct or method of initiation into any student organization, whether on public or private property, which willfully or recklessly endangers the physical or mental health of any student or other person. Such conduct shall include whipping, beating, branding, forced calisthenics, exposure to the weather, forced consumption of any food, liquor, beverage, drug or other substance, or any other brutal treatment or forced physical activity which is likely to adversely affect the physical health or safety of any such student or other person, or which subjects such student or other person to extreme mental stress, including extended deprivation of sleep or rest or extended isolation. Section 18: Whoever knows that another person is the victim of hazing as defined in section seventeen and is at the scene of such crime shall, to the extent that such person can do so without danger or peril to himself or others, report such crime to an appropriate law enforcement official as soon as reasonably practicable. Whoever fails to report such crime shall be punished by a fine of not more than five hundred dollars. Section 19: Each secondary school and each public and private school or college shall issue to every group or organization under its authority or operating on or in conjunction with its campus or school, and to every member, or applicant for membership in such group organization, a copy of this section and sections seventeen and eighteen. An officer of each such group or organization, and each individual receiving a copy of said sections seventeen and eighteen shall sign an acknowledgment stating that such group, organization or individual has received a copy of said sections seventeen and eighteen. Each secondary school and each public or private school or college shall file, at least annually, a report with the regents of higher education and in the case of secondary schools, the board of education, certifying that such institution has complied with the provisions of this section and also certifying that said school has adopted a disciplinary policy with regards to the organizers and participants of hazing. The board of regents and in the case of secondary schools, the board of education shall promulgate regulations governing the content and frequency of such reports, and shall forthwith report to the attorney general any such institution, which fails to make such report. Passed to be enacted by the House of Representatives November 13, 1985. Passed to be enacted by the Senate November 14, 1985. Approved November 26, 1985 by Governor Michael J. Dukakis.
Your answer
Student-Athlete Handbook *
I have read and understand the terms of the Student-Athlete handbook located on the Maynard Athletics Website. Please note the change in Chemical Health policy to require counseling after second violation and a change to the academic policy to only allow one failed class for eligibility.
Your answer
Activity Fee *
I understand that the Activity Fee must be accounted for in order for my son(s) or daughter(s) to participate in interscholastic contests. Failure to comply with this rule may cause your athlete to be unable to participate in games.
Your answer
On March 14, 2016, Governor Charlie Baker signed landmark legislation into law to address the deadly opioid epidemic plaguing the Commonwealth. The bill is titled An Act relative to substance use, treatment, education and prevention (STEP Act). Below is a link to information about drug abuse and education. http://www.mass.gov/eohhs/gov/departments/dph/programs/community-health/dvip/injury-prevention/substance-use-disorder.html. *
I have read and watch videos pertaining to drug abuse and prevention.
Your answer
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