Fr. Tolton Catholic H.S. 2024-2025 Permission to Participate Form

Every Tolton student and a parent/guardian MUST complete this Permission to Participate form in order to participate in any school activities.

 

This form must be filled out by both the parent/guardian and student together.
Please read very carefully. Parent/guardian and student signatures are required. 

 

It will take approximately 15-20 minutes to complete the following form. We suggest using a device other than a phone to complete this form.

 

 Please complete 1 form per student.

 

Complete by August 11, 2024.

Permission to Participate
My son/daughter, named above, has my permission to participate in activities including sports, fine arts events, field trips, retreats, and service projects during this school year at Fr. Tolton Catholic High School and to travel on the transportation provided or arranged by Fr. Tolton Catholic High School.  I understand that this is not a comprehensive list of activities; however, I also understand that the school will provide additional details as events arise.

Indemnification and Waiver & Release
The undersigned parent/guardian of the above-named student acknowledges the inherent risks of participation in activities and associated travel and recognizes that injuries, some extremely serious and even resulting in death, can and do occur as a result of such participation. Participants agree to engage in these activities at their own risk and release and discharge Fr. Tolton Catholic High School from any and all claims of negligence by the school and its employees. The undersigned agrees to save, indemnify, and keep harmless Fr. Tolton Catholic High School, the Tolton Catholic Board and its personnel including volunteers, and the Diocese of Jefferson City against any and all liability, claims, judgments, or demands for damages arising as a result of injuries sustained while participating in Fr. Tolton Catholic High School activities.

Agreement to Comply
My student and I have read, understand, and agree to comply with the Fr. Tolton Catholic High School Rules and Regulations for this school year as stated in the school handbook. We agree to accept the penalties for violations. We acknowledge the following:

• Any student not at school by 9:45am will not be eligible to participate in practice, contests, rehearsals or any co-curricular events that day, unless the absence has been pre-approved by the school administration. 
• A student may not leave school early to go home ill and then participate in an activity.   
• In the event that a student must miss school for doctor’s appointments, physical therapy, etc., the student must return to school within 1 hour and 45 minutes from the time he/she leaves, or he/she may not participate in practices, rehearsals, dances, plays, games, events, etc. that day.  In addition, the school office must be notified.
• A student will not be eligible to participate on any subsequent date until the student attends a full day of classes or is excused by the school administration. (See MSHSAA By-Law 2.2.3)
   

Physical Readiness and Treatment Authorization
If my student participates in sports, the undersigned parent/guardian of the above-named student certifies that the student is free from communicable diseases and is fit for full and vigorous participation in sports. Further, the undersigned grant consent for representatives of Fr. Tolton Catholic High School to seek medical attention and all medical care as prescribed by a duly licensed physician administered under any and all conditions as necessary to preserve life, limb, or well-being of the student. Additionally, the undersigned grant consent for representatives of PEAK/Sport and Spine (athletic trainers provided) to treat any and all injuries/medical conditions associated with athletic participation, including but not limited to concussions, heat illnesses (use of rectal thermometers in the event of a severe medical emergency), minor to severe injuries, general illnesses, and the providing or rehabilitative physical therapy related to injuries, etc. 

Pending Legal Problems
If my student participates in a MSHSAA-regulated sport/activity, the undersigned parent/guardian of the above-named student understands that MSHSAA rule requires that if my son/daughter encounters a problem with the law, I must contact the Athletic Director by the end of the next school day to inform them. I further understand that failure to do so could result in my son/daughter being declared ineligible for the remainder of the sports season as it may result in a scenario in which games could be forfeited. MSHSAA rule prohibits participation by any student who has a pending problem with the law until the court-ordered sentence has been completed, and/or all legal proceedings have been cleared up.

Student Release of Information
If my student participates in a sport/activity, I hereby authorize the athletic trainers/physicians to release information regarding the health status of my son/daughter to their coach as it relates to their ability to participate in the care of their injuries/illnesses.

If yes to the preceding question, you may be asked to provide appropriate documentation to the school stating you are cleared to participate by a health care professional (MD/DO/ARNP/PA/ATC) for those medical conditions/concussions/orthopedic injuries.

Informed Consent: By its nature, participation in interscholastic athletics/activities includes risk of serious bodily injury and transmission of infectious disease such as HIV, Hepatitis B, severe acute respiratory syndrome (COVID-19) and/or any mutation or variation thereof. Although serious injuries are not common and the risk of HIV transmission is almost nonexistent in supervised school athletic/activity programs, it is impossible to eliminate all risk. Participants must obey all safety rules, report all physical and hygiene problems to their coaches, follow a proper conditioning program, and inspect their own equipment daily. PARENTS, GUARDIANS, OR STUDENTS WHO MAY NOT WISH TO ACCEPT RISK DESCRIBED IN THIS WARNING SHOULD NOT SIGN THIS FORM. STUDENTS MAY NOT PARTICIPATE IN MSHSAA- SPONSORED SPORT WITHOUT THE STUDENT’S AND PARENT’S/GUARDIAN'S SIGNATURE.

 

I understand that in the case of injury or illness requiring transportation to a health care facility, a reasonable attempt will be made to contact the parent or guardian in the case of the student being a minor, but that, if necessary, the student will be transported via ambulance to the nearest hospital.

 

We hereby give our consent for the above student to represent his/her school in interscholastic athletics/activities. We also give our consent for him/her to accompany the school group on trips and will not hold the school responsible in case of accident, injury or illness whether it be en route to or from another school or during practice or an interscholastic contest; and we hereby agree to hold the school district of which this school is a part and the MSHSAA, their employees, agents, representatives, coaches, and volunteers harmless from any and all liability, actions, causes of action, debts, claims, or demands of every kind and nature whatsoever which may arise by or in connection with participation by my child/ward in any activities related to the interscholastic program of his/her school.

 

In the event of an emergency or when the Parent(s) or Guardian(s) is unable to directly supervise health care services needed by the student for injuries or illnesses sustained at any athletic/sport and/or activity practice, conditioning exercise or contest, I also give my consent to the rendering of necessary health care services for the student by a qualified provider (QP) covering the athletic/activity practice, conditioning exercise or contest, including an athletic trainer, physician, physician assistant, nurse practitioner or other medically-trained professional licensed by the State of Missouri (or the state in which the student injury or illness occurs) and who is acting in accordance with the scope of practice under their designated state license and any other requirement imposed by state law. In emergency situations, the QP may also be a certified paramedic or emergency medical technician for the purpose of providing emergency health care and transport. Health care services are defined as services including, but not limited to, evaluation, diagnosis, first aid, emergency care, stabilization, treatment and referral. I further authorize the QP who provides such health care services to disclose such information about the student’s injury or illness, diagnosis, care and treatment in the professional judgment of the QP to the student’s athletic director, coaches/directors, school nurse and any classroom teacher required to provide academic accommodation to assure the student’s recovery and safe return to activity. If the Parent(s) or Guardian(s) believes that the student is in need of further evaluation, treatment, rehabilitation or health care services for the injury or illness, the student may be treated by the physician or provider of his or her choice.

 

To enable MSHSAA to determine whether the herein named student is eligible to participate in interscholastic athletics/activities in the MSHSAA member school, I consent to the release of any and all portions of school record files to MSHSAA, beginning with sixth or seventh grade, of the herein named student, specifically including, without limiting the generality of the foregoing, birth and age records, name and residence address of parent(s) or guardian(s), residence address of the student, academic work completed, grades received, and attendance data.

 

We confirm that this application for the above student to represent his/her school in interscholastic athletics/activities is made with the understanding that we have studied and understand the eligibility standards that our son/daughter must meet to represent his/her school and that he/she has not violated any of them. We also understand that if our son/daughter does not meet the citizenship standards set by the school or if he/she is ejected from an interscholastic contest because of an unsportsmanlike act, it could result in him/her not being allowed to participate in the next contest or suspension from the team or group either temporarily or permanently.

 

I consent to the MSHSAA’s use of the herein named student’s name, likeness, and athletic/activity-related information in reports of contests, promotional literature of the Association and other materials and releases related to interscholastic athletics.

 

We further state that we have completed that part of this certificate which requires us to list all previous injuries or additional conditions that are known to us which may affect this athlete's performance or treatment and we certify that it is correct and complete.

 

The MSHSAA By-Laws provide that a student shall not be permitted to practice or compete for a school until it has verification that he/she has healthcare insurance coverage or healthcare expense payment plan.

This application to represent my school in interscholastic athletics/activities is entirely voluntary on my part and is made with the understanding that I have studied and understand the eligibility standards that I must meet to represent my school and that I have not violated any of them.

 

I have read, understand, and acknowledge receipt of the MSHSAA brochure shown above entitled "How to Maintain and Protect Your High School Eligibility" which contains a summary of the eligibility rules of the MSHSAA. (I understand that a copy of the MSHSAA Handbook is on file with the principal and athletic administrator and that I may review it in its entirety, if I so choose. All MSHSAA by-laws and regulations from the Handbook are also posted on the MSHSAA website at www.mshsaa.org/handbook.

 

I understand that a MSHSAA member school must adhere to all rules and regulations that pertain to school-sponsored, interscholastic athletics/activities programs, and I acknowledge that local rules may be more stringent than MSHSAA rules.

 

I also understand that if I do not meet the citizenship standards set by the school or if I am ejected from an interscholastic contest because of an unsportsmanlike act, it could result in me not being allowed to participate in the next contest or suspension from the team or group either temporarily or permanently.

 

I understand that if I drop a class, take course work through Post -Secondary Enrollment Option, Credit Flexibility, or other educational options, this action could affect compliance with MSHSAA academic standards and my eligibility.

 

I understand that participation in interscholastic athletics/activities is a privilege and not a right. As a student participant, I understand and accept the following responsibilities:

• I will respect the rights and beliefs of others and will treat others with courtesy and consideration.

• I will be fully responsible for my own actions and the consequences of my actions.

• I will respect the property of others.

• I will respect and obey the rules of my school and laws of my community, state, and country.

• I will show respect to those who are responsible for enforcing the rules of my school and the laws of my community, state, and country.

MSHSAA revised their MSHSAA Preparticipation Physical Forms/Procedure April of 2023. 

 

Each student should take the MSHSAA Preparticpation Physical form with them to their doctor. This form can be found here: MSHSAA Preparticipation Physical Form

 

New students, your previous school will not transfer your MSHSAA Preparticipation Physical Form to Tolton. For this reason, you must submit to Tolton a valid copy of your MSHSAA Preparticipation Physical Form, either in paper form or digitally. All physicals are valid for 24 months from date of examination.

 

Though, this form is given to the doctor, Tolton only receives the last page. For this reason, we strongly encourage that the parent/guardian complete the following medical history information so that Tolton's Athletic Trainers have and/or the team physician has the medical information to assist in the treatment of student athletes.

 

As a reminder, in addition to completing this form each year, students must submit a Sports Physical every two years. To submit a new Sports Physical, MSHSAA Medical Eligibility Form (Step 3), send it to Jeremy Osborne, Tolton Assistant Athletic Director at josborne@toltoncatholic.org, or fax it to 573-445-7703 or submit a copy to the Office. 

By signing below, we agree to all statements above and acknowledge that they apply to all students listed herein. We also hereby state, to the best of our knowledge, that our answers to the questions listed throughout this form are complete and correct.

Thank you for completing the required information for your student. If you have any questions or concerns please do not hesitate to reach out to Jeremy Osborne, Tolton Assistant Athletic Director at josborne@toltoncatholic.org. 

 

Click Submit to finish.