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Bulldog Athletics

Portland High School

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Bulldog Athletics

Portland High School

Bulldog Athletics

Portland High School

Athletic Documents


PORTLAND PUBLIC SCHOOLS

CO-CURRICULAR TRANSPORTATION WAIVER

RELEASE AND AGREEMENT TO HOLD HARMLESS

(COACHES PLEASE KEEP WITH YOU AFTER PARENT/GUARDIAN HAS SIGNED)

(     )     LIST OF PEOPLE WITH WHOM MY CHILD MAY RIDE:

 

NAME                                                                                                            PHONE NUMBER

 

_____________________________________________________________________________

 

_____________________________________________________________________________

 

_____________________________________________________________________________

(     )     Only in an emergency will I release my child to a responsible adult other than those listed above.

(     )     I grant permission for my child to ride home with any responsible adult.

In consideration of my child being released from bus transportation as set forth above, I agree to assume all risk of and hereby waive, release, and agree to indemnify and hold harmless the Portland School Department, its governing board, administrators, agents, and employees (Releases), from and against any and all liability, actions, damages, and claims of any kind or nature whatsoever, whether or not caused by the negligence of Releases, for any injury, harm or damage to my child or his or her property that may arise or occur during or in connection with such transportation.  I further agree that if I or any successors assert any claim in contravention of this agreement, I or they will be liable for the expenses, including legal fees, incurred in defending such claim.

 

I have read this document carefully before signing it, understand its terms, recognize that it constitutes a waiver of legal rights, and intend it to be enforceable to the greatest extent allowed by law.

 

 

STUDENT NAME:_________________________________________________

 

 

______________________________________________                            _____________________

Signature of Parent/Guardian                                                                               Date

 

PORTLAND PUBLIC SCHOOLS

 

CO-CURRICULAR TRANSPORTATION WAIVER

RELEASE AND AGREEMENT TO HOLD HARMLESS

 

 

The expectation we have for students involved in co-curricular activities is that they ride to and from the event on the bus provided by the Portland Public Schools.  However, it is recognized that circumstances may dictate that students may not be able to ride the bus home from an away contest.

 

To that end, you are asked to sign this Transportation Release Form that will be in effect for the duration of the season.  You may provide a list of the only people with whom your child may leave with, OR, you may opt to allow your child to leave with any responsible adult. 

Failure to sign and return the release implies that your son/daughter will always ride to and from the events on the team bus provided by the Portland Public Schools.

 

PORTLAND PUBLIC SCHOOLS CO-CURRICULAR

ACTIVITIES CODE OF CONDUCT AGREEMENT

 

            By their signature, students and their parents acknowledge that they understand and agree to adhere to the PPS Co-curricular Activities Code of Conduct.  Disciplinary action taken under this code by a coach, activity advisor, or co-curricular activities director may be appealed to the principal of the school.  It is recognized that individual activity advisors or coaches may have additional rules and regulations for their students in areas not covered by the code.

 

I HAVE READ AND UNDERSTAND THE CODE OF CONDUCT AND BY MY SIGNATURE AGREE TO ABIDE BY IT.

_______________________________________________                  ________________

Student Signature                                                                                                           Date

I HAVE READ AND UNDERSTAND THE CODE TO WHICH THE STUDENT IN MY CUSTODY HAS AGREED TO BY HIS/HER SIGNATURE.

_______________________________________________                  ________________

Parent/Guardian Signature

 

 

 

 

 

 

WAIVER OF LIABILITY EXTRA CO-CURRICULAR ACTIVITY

TRANSPORTATION

I hereby give my permission for __________________________of ___________________

                                                            Student Name                                               School Name

to participate in __________________________.At locations away from the school within the City of Portland.  In giving my permission, I understand that the school department is not providing transportation to or from the above extra/co-curricular activity within the City of Portland, and agree that I am therefore solely responsible for transporting my son/daughter to and from that activity, and for taking all precautions necessary to do so in a safe and adequate manner.

          Because the school department is not providing transportation, within the City of Portland, and therefore cannot control such transportation, I agree to release and hold the school department and its agents and employees harmless from any liability, claims, demands, costs, or damage arising out of any such transportation which I or my son/daughter might have.

            I have read this document carefully, and sign it voluntarily with full knowledge of its significance.

_______________________________________________                  ________________

                  Signature of Parent/Guardian                                                                                                   Date

Note:  This form must be signed in order for the student to participate in the Activity (ies) above.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Portland High School

EMERGENCY INFORMATION FORM

(COACHES PLEASE KEEP THESE IN  YOUR MEDICAL BOX)

 

NAME__________________________________________

DATE OF BIRTH:________________________________

AGE:______                                            GRADE:_______

ADDRESS:______________________________________

HOME PHONE:____________________________

FATHER’S WORK PHONE:__________  MOTHER’S WORK PHONE: _____________

IF PARENTS CANNOT BE CONTACTED IN AN EMERGENCY – PLEASE NOTIFY:

_________________________________ AT ________________________________

      (RELATIONSHIP)                                                             TEL #

FAMILY DOCTOR NAME & TEL:_______________________________________

INSURANCE COMPANY______________________________POLICY #_________

POLICY HOLDER______________________________________________________

KNOWN ALLERGIES___________________________________________________

The team physician, athletic trainer and coach may apply first aid treatment until the family member/doctor can be reach?  ___________(yes)   ___________(no).

 

We give our consent for coaches, athletic trainers and team physicians to use their own judgment security medical attention and EMS services in case the parent/guardians cannot be reached?  ___________(yes)   ___________(no).

____________________   ______________________________________________

          DATE                                                 PARENT/GUARDIAN SIGNATURE

 

 

 

 

 

 

 

 

 

 

 

 

PORTLAND PUBLIC SCHOOLS

WARNING FORM

SPORT/ACTIVITIY (CHECK ALL THAT APPLY)

___Baseball ___Basketball ___Cheerleading ___Cross Country ___Drama ___Field Hockey

___Football ___Golf ___Ice Hockey ___Lacrosse ___Nordic Ski ___Soccer

___Softball ___Swimming ___Tennis ___Track Indoor ___Track Outdoor ___Wrestling

WARNING, AGREEMENT TO OBEY INSTRUCTIONS, REPORT INJURIES, AND PARENTAL PERMISSION

I am aware that playing or practicing to play/participate in any co-curricular activity can be dangerous activity involving many risks or injury. I understand that the dangers and risks of playing or practicing to in the above co-curricular activity include the risk of serious injury. Because of those dangers and risks, I recognize the importance of following coaches’/advisors’ instructions regarding playing and training techniques, team or program rules, etc., and agree to obey such instructions.

I agree to report all injuries to me to my coach, advisor, or principal within 24 hours of their occurrence. Date:___________________ ____________________________________________

Signature of Student

*******************************************************************************************************************************

I, the parent/guardian of _______________________________, understand the dangers and risks involved Name of Student

in the co-curricular activity as indicated above. Recognizing those dangers and risks, I give permission for my son/daughter to participate in all activities of the co-curricular activity.

Date: ___________________ _______________________________________________

Signature of Parent/Guardian

Note: This form is for student participation in extramural or intramural co-curricular activities. This form must be signed and returned in advance to the student’s building principal for the student to
Participated in the co-curricular activity.

I give permission for my son/daughter to use the school’s whirlpool bath for minor injuries, with approval of the school athletic trainer or supervisor of the sport/athletic activity.

Date: ________________________ ___________________________________________

Signature of Parent/Guardian



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