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General Information and Instructions
Parents must read over this page and sign the form below every year their child(ren) wish to participate in sports at MHCS. Please review the information and submit your signature at the bottom indicating you have reviewed the necessary information, agree to abide by the policies outlined below, and give your child permission to participate in athletics at MHCS.
Your child(ren) must also submit the athlete agreement form, if they wish to participate in sports at MHCS.
Parent Agreement
CONCUSSION INFORMATION
As a parent/guardian it is important to recognize the signs, symptoms, and behaviors of concussions. By signing this form you are stating that you have read the concussion information sheet and understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head injury. There is an additional video with helpful concussion information that you may also review.
By signing below, I confirm that:
- I have read the Parent Concussion and Head Injury Information, and understand what a concussion is and how it may be caused. I also understand the common signs, symptoms, and behaviors of a concussion. I agree that my child must be removed from practice/play if a concussion is suspected.
- I understand that it is my responsibility to seek medical treatment if a suspected concussion is reported to me.
- I understand that my child cannot return to practice/play until I provide written clearance from an appropriate health care provider to his/her coach.
- I understand the possible consequences of my child returning to practice/play too soon.
ATHLETIC STATEMENT OF PERMISSION
My child has permission to participate as a member of the basketball/volleyball/track/softball/football team at Mount Horeb Christian School. I have read the requirements established for the players and will assist in every way to see they are enforced. I hereby release Mount Horeb Christian School, its employees, agents, and representatives, from and in connection with any claim arising out of the participation by the undersigned’s child in interscholastic sports sponsored by the school, whether held on or off of school premises.
The undersigned confirms that the child has insurance coverage and grants permission for any medical treatment deemed necessary while such child is under the supervision of the school as a participant in such activities. In the event that such a child becomes ill or sustains an injury while involved in interscholastic sports, the undersigned gives permission to those in charge of such activity to take whatever steps are necessary to stop any bleeding, and administer first aid to such child.
The undersigned also consents to an x-ray examination, anesthetic, medical, dental, or surgical diagnosis and treatment and hospital care, and the administration of drugs or medicine to be rendered to such child, which is recommended by a duly licensed physician. The undersigned agrees that this consent for medical treatment shall apply to all emergency situations and that a copy of this consent is as valid as the original. The purpose of this consent for medical treatment and release is to allow emergency treatment of such child in the event that the undersigned cannot be reached to authorize such treatment.