Sport Participation Checklist

All information within the tabs below must be completed before a student may participate in a Viera Charter School Sport:

Student Information Form
Information Consent/General Release Form
Parent & Athlete Code of Conduct Form
Heads Up: Concussion - Information
EL2 & EL3 - Print & return hard copies to Athletic Department
EKG Clearance - Print & return hard copy to Athletic Department
Sports Fee via MySchoolBucks.com once the student is chosen for the team.

Athletic Department Student Information

Student Namerequired

First Name

Last Name

Home Phone

Address 1required

City

Zip

Genderrequired

Shirt Sizerequired

Date of Birthrequired

Must contain a date in M/D/YYYY format

Agerequired

Select Grade Levelrequired

Elementary

Middle School

Parent or Guardianrequired

Daytime Phone required

Additional Parent or Guardian

Daytime Phone

Alternate Emergency Contact Personrequired

Relationshiprequired

Phone Numberrequired

Medical Insurance Companyrequired

Policy #required

Family Physicianrequired

Phone Numberrequired

Address

City

List Allergies or Special Conditionsrequired

State none if applicable

NOTE: In the event of a medical emergency situation, even with the form, the chaperone will attempt first to contact the student's parent/guardian.

Informed Consent & General Release

On behalf of the administration, faculty, staff, and students of VCS, we welcome you to our athletic facility and program. The schools competing are members and have agreed to abide by the constitution and bylaws of the Brevard Charter Athletic League to insure the highest possible standards of conduct in their interscholastic programs.

We ask that everyone demonstrate an attitude of good sportsmanship throughout the season. Respect is a right for the athletes, coaches, faculty, administration, and officials. Any spectator not displaying appropriate conduct will be asked to leave the facility. Your cooperation is expected and appreciated.

ATHLETE EXPECTATIONS:
SPORTS FEE: Sports fee must be paid prior to first competition of the season to be paid at MYSCHOOLBUCKS.COM print receipt turn in with pack.
Grades & Behavior: Students must have passing grades and behavior in all classes. Student athletes are a representation of VCS and they are to follow the expectations list below.
Grade Check: Each student’s grades will be checked weekly by the athletic director and coach to ensure eligibility. An athlete will be considered ineligible if:

If an athlete receives a 70% or lower, they will not be able to play for the week. Grades must improve by the next week. See consequences below.
If a student athlete has been absent and as a result has a “D” or “F” in a class because the makeup work has yet to be GRADED, their playing time will be limited or will not be able to play until the work has been TURNED in.
Student athletes who have a “D” on their grade check will have very limited playing time or no playing time. This is under the coach’s discretion and will be discussed with the athletes at the beginning of the season.

Grades/Behavior Consequences: In an event where an athlete’s self-discipline breaks down in the area of grades, behavior, or attendance, the following actions will be taken.

1^st offense: one on one meeting with coach and possible game suspension.
2^nd offense: Conference with athlete and parent along with game suspension.
3^rd offense: Dismissal from team. (If a student athlete receives an “F” a 3^rd time on the grade check, the student athlete will be dismissed from the team so that they can focus on academics) Dismissal from team will occur if the student has committed a severe disciplinary action steps may be accelerated due to severity of behavior.

EQUIPMENT AND UNIFORMS:

Students will be held responsible for all athletic equipment issued to them.
School uniforms are to be used or worn only under three strict conditions: Competition / Informed by the school administration.
Students are responsible for taking care of their uniform.
Students are responsible for having all required equipment needed to compete.

Attendance: Student athletes are required to be at tryouts, practices, and games. An athlete cannot be adversely treated due to an excused absence. However, absent athletes may have to work hard to regain their previous playing status. Student athletes who have a medical excuse to excuse them from PE may not participate in athletics.

The athletes who attend all practices and competitions must be given consideration for their commitment. Athletes should inform their coach well before hand if they plan to miss a practice or a competition. Please see the “consequences” for unexcused absences. Examples of excused absences (doctor’s appointment, family emergency, absent from school). Students must be in school for half of the school day in order to participate in a game or competition on that day.

Required

Heads Up: Concussion

EL2 & EL3

Transportation Liability Form

Required

AUTHORIZATION AND REQUEST FOR TRANSPORTATION OF STUDENT IN PRIVATELY OWNED VEHICLE AND RELEASE OF LIABILITY FORM

Transportation in private vehicles will be necessary during an athletic season at Viera Charter School. We often depend on coaches and parent volunteers to help transport players to games. Each athlete’s parent(s) or guardian(s) must give prior written consent for the student to be transported by private vehicle. Each vehicle operator must be licensed and carry liability insurance coverage required by Florida State Law. All automobiles used for transportation must be insured and in safe operating condition.

Student Namerequired

First Name

Last Name

Select grade level for your studentrequired

Elementary

Middle School

I give my consent for my student to be transported by private vehicle.requiredApplicable only for practices, games, and other related Sport(s) activities.

YES

Applicable only for practices, games, and other related Sport(s) activities.

Acknowledgmentrequired

By submitting this form, I agree to release Viera Charter School, including its agents, employees, representatives, coaches and volunteers, from any liability in connection with being transported by private vehicle.

E-Signature of Parent/Guardianrequired

First Name

Last Name

Volunteer Driver Form

Required

DRIVER VOLUNTEER ACKNOWLEDGMENT

Event/Sport/Activityrequired

Destinationrequired

Please select the coordinating grade level you are volunteering for:required

Elementary

Middle School

Name of DriverrequiredMust be over 18-years of age

First Name

Last Name

Must be over 18-years of age

Vehicle Informationrequired

Make / Model / License Plate Number

Driver License Number required

Valid License only

Current vehicle Liability Insurance with minimum coverage 50/100/20required

Carrier Name / Policy Number

E-Signature of Parent/Guardian

First Name

Last Name

Acknowledgmentrequired

By submitting this form, I acknowledge that as a volunteer, I agree to provide transportation for the school-related function identified below and I affirm the following:

My vehicle is in a safe, serviceable operating condition and there are seat belts for each passenger.
I am aware that I must travel directly to and from events.

Quicklinks

In This Section

Sport Participation Checklist

Student Information

Athletic Department Student Information

Informed Consent & General Release

Code of Conduct

Heads Up: Concussion

EL2 & EL3

Transportation Liability Form

Volunteer Driver Form

EKG

ALL MIDDLE SCHOOL ATHLETES NEED TO HAVE THIS FORM COMPLETED.