MHS Lacrosse Club

Emergency Information Form

Please Print:

Student’s Name                      _____________________________________  Age  ___

Social Security Number          ______________________________________________

Parent/Guardian’s Name         ______________________________________________

Address                                   ______________________________________________

                                                ______________________________________________

Home Telephone Number       ______________________________________________

Parent Cell Phone Number     ___________________Work Number _______________

Parent Email Address             ______________________________________________

Emergency Contact Information

Contact Name and Phone Number  __________________________________________

Insurance Company and Policy Number(s)

________________________________________________________________________________________________________________________________________________

                                             MHS Lacrosse Club

Insurance Requirements

Lacrosse is a fast and physical sport, and injuries can occur.  Although every effort is made to insure the player’s safety, accidents and injuries can still happen.  All players and parents are urged to consider whether they are willing to take these risks and if they have enough insurance coverage before agreeing to participate in the club. 

It is expected that each player and coach will be covered by their own individual and/or family medical insurance plan.  The Mandeville Lacrosse Club assumes no liability for injuries and is hereby notifying each player that he/she is playing at their own risk.

Furthermore, it is expected and required that each player and coach will become a member of the U.S. Lacrosse Association.   By becoming a member, a limited insurance policy is offered through BollingerLAX.  Membership can be completed at www.uslacrosse.org.  Information on the insurance can also be acquired on this site.  It is mandated by the league and the MHS Lacrosse Club that each player and coach must be a full and current member of this organization before participating in any MHS Lacrosse Club activity, clinic, practice, game, etc.  Membership numbers must be provided to the club on the attached forms.  This is an individual requirement that must be met before actively participating in the MHS Lacrosse Club.  The MHS LAX Club will not be providing membership in the US Lacrosse Association.

In addition, additional secondary coverage can be acquired through a program offered by United Healthcare in conjunction with STPSB.  United Healthcare Insurance can be accessed through www.k12StudentInsurance.com or by telephone at 1-800-409-5733.

Please sign below to indicate that you have been notified of these requirements and that you understand them.

Parent/Guardian Name __________________________________________  Date  __________

Parent/Guardian Signature _______________________________________________________

Player Name  ___________________________________________________  Date __________

US Lacrosse Code of Conduct

US Lacrosse requires all players, coaches, officials, parents and spectators to sign and abide by a "Code of Conduct" that embodies basic common sense principles, demonstrates consideration of others, and projects a positive image to our young men and women.

Individuals and/or teams participating in US Lacrosse events that fail to abide by this code will be subject to ejection and disqualification from future US Lacrosse events. Thank you for your help in promoting these principles.

The Code of Conduct

Players, coaches, spectators and parents are to conduct themselves in a manner that ""Honors the Game"" and demonstrates respect to other players, coaches, officials and spectators. In becoming a member of the lacrosse community an individual assumes certain obligations and responsibilities to the game of lacrosse and its participants. The essential elements in this ""Code of Conduct"" are HONESTY and INTEGRITY. Those who conduct themselves in a manner that reflects these elements will bring credit to the sport of lacrosse, themselves, their team and their organization. It is only through such conduct that our sport can earn and maintain a positive image and make its full contribution to youth sports in the United States and around the world. US Lacrosse and its Youth Council support the following behaviors for those participating or involved in any way with US Lacrosse and youth lacrosse in general:

The essential elements of the "Code of Conduct" must be adhered to.

o    Sportsmanship and teaching the concepts of fair play are essential to the game, and must be taught and developed both at home and on the field during practices and games.

o    The emphasis on winning should never be placed above the value of good sportsmanship, the concepts of fair play, or the skills of the game.

o    Derogatory comments are unacceptable. Use positive reinforcement with players and adults alike. It should be remembered that criticism, once made, can never be retracted.

o    The safety and welfare of the players are of primary importance.

o    Coaches must always be aware of the tremendous influence they have on their players. They are to strive to be positive role models in dealing with young people, as well as with adults.

o    Officials are expected to conduct themselves as professionals and in a manner that demonstrates courtesy and fairness to all parties while exercising their authority on the field.

o    Adults involved with the game must never permit anyone to openly or maliciously criticize, badger, harass, or threaten an official.

o    Knowledge of the Rules of Lacrosse must be respected and adhered to by all who participate in the game of lacrosse, both in the letter and the spirit of the game. Attempts to manipulate rules in an effort to take unfair advantage of an opponent, or to teach deliberate unsportsmanlike conduct, is considered unacceptable conduct.

o    Eligibility requirements, such as age and previous level of participation, must be followed. They have been established to encourage and maximize participation, as well as promote safety.

MHS Lacrosse Club Code of Conduct

The MHS Lacrosse Club is an organization that follows a code of conduct.  This code is to be honored by all players at all times.  To be a member of this team is to be part of a brotherhood of friends and fellow lacrosse players.  The following conduct will be expected of all players at all times, all times meaning games, practices and off field engagements.

·   Players will be respectful of the coaching staff and one another at all times.

·   Drug and alcohol abuse prior to or during team events will not be tolerated.  If a player is found under the influence at any of these times the player will be asked to leave the field/event and parent notification will occur.  A referral will be filed with the MHS administration for further disciplinary action from the school and school district.

·   Players will be respectful of other teams and their coaching staffs during all games and tournaments. 

·   Because they are representatives of their school, coaches and team, all players will be expected to behave as the responsible young adults that they are, especially during away games, tournaments and events.

·   Players will be respectful of the time they have at practice and will not be disruptive.

·   Any players not adhering to this code of conduct may be subject to additional physical training or benched during gametime(s).

·   Continued violation of the code of conduct will result in a parent-coach conference.

·   If violation of the code of conduct continues after the parent-coach conference and resolution cannot be found, the player may be removed from the team.

·   The Coaching staff wants the players to be aware that this is their team as well and that their opinion matters.  The players should feel comfortable with approaching the coaching staff to discuss their opinion at an appropriate time, whatever it may be.

Attendance Policy:

All players who may miss a practice must notify one of the coaches of this pending absence before it occurs.  It is understood that there will be emergencies, etc. that may keep a player from attending a practice, and these will be excused based on the coaching staff’s evaluation.  If a student fails to notify the coaching staff and does not attend a practice, this will be considered an unexcused absence.   If this occurs within 2 days prior to a game, regardless of past attendance history, the player will have limited or no game playtime for that game.   The player must still attend the game, suit up and be on the sidelines with his team.   Failure to do this will constitute 2 unexcused absences.

If a student has 5 unexcused absences accumulated, they will not be allowed to play in the next game following that string of absences.  They are still be required to attend the game in uniform and sit on the bench.  Once the player sits out that game, the slate is wiped clean until the next game.  For example, Billy misses practice Monday and Tuesday, he then has limited or no playtime in the game on Thursday.  He then misses practice again on Monday, Tuesday and Wednesday, that would total 5 unexcused absences and he would not be allowed to play in the game on Friday.  After sitting out the game on Friday, he would again be eligible to play in the next game.

Participation Policy: 

Each team member is required to attend practice, games, and all other team functions. 

Participation at practice: Being on time and practicing with the team on drills and other skill enhancing practice drills.  Also, staying until the end of practice is considered a part of participation.  If a student is injured and unable to run drills at practice, they are still required to attend the practice.  A doctor’s excuse may be requested.

Participation at the games: Being on time to the pre-game preparation.  This would mean that the student would need to be suited up and on the field participating in drills or stretching at the required time. 

For example, if a game starts at 6:30 and it has been requested that all players be in attendance at 5:30, the student would need to be suited up and on the field stretching at 5:30. These times will be given out at practice prior to the game.  If a student is unable to play due to an injury or a “no pass no play” situation, they are still required to suit up and sit with the team and support their teammates during the game.

 Participation in all other Team Functions: In addition to those listed above, all other team functions will require the participation of the student.  In the event that a student would not be able to participate, this would need to be discussed prior to the event with the Head Coach and/or Faculty Sponsor. 

 No Pass - No Play Policy:

The MHS Lacrosse team follows a No Pass No Play policy.  This will ensure that the students’ energy is focused on maintaining good grades, as well as becoming a great lacrosse player.  If a student does not pass a class, they will be ineligible to play in any games for the 2 weeks following the receipt of the failing grade.  At the end of each nine weeks (quarter), the students will be required to bring a copy of their report card to the faculty sponsor.  The student will only have a 4-day grace period after the report card is issued to get a copy to the faculty sponsor.  If the report card is not received by that point, the student will be considered ineligible for the following two weeks, thus meaning that they would not be able to participate in any games for two weeks. 

Agreement:

I have read and understand the above Code of Conduct and agree to abide by the rules and policies set forth by the MHS Lacrosse Club, Mandeville High School and the St. Tammany Public School District Student/Parent Handbook.

Player’s Name (print)______________________________________________________________

Player’s Signature  ____________________________________________  Date  ______________

Parent/Guardian Name (print) _______________________________________________________

Parent/Guardian Signature  _____________________________________  Date  ______________

Mandeville High School

Boys Lacrosse Club

1 Skipper Drive

Mandeville, LA 70471

MHS Lacrosse Club Away-Game Travel Permission Form

The MHS Lacrosse Club will be traveling to several games and tournaments during the 2010-2011 season.  All members of the club not travelling on the team bus MUST ride with a club parent/guardian to the event.  No member may drive themselves.  Failure to follow this policy will make the player ineligible for play at the away games and for following games.  Failure to have a signed permission slip on file with the faculty sponsor will also make the player ineligible for play at that particular game and face suspension from future practices and games. 

Please sign and date the form below to indicate that you are aware and will follow this MHS and St. Tammany School District policy.  You must return the signed form with the Player Packet no later than December 15, 2011 to the club sponsor and coach, Dr. Mark Hazlett (room 205).  No late forms can or will be accepted.

Members of the club will leave and return from the MHS parking lot for team travel at times and dates specified.  No one will be picked up or dropped off at any other location.  In addition, please have your ride home meet you at the MHS parking lot.  Be on time and be prepared for play. 

______________________________________________  Student

______________________________________________  Student’s Parent / Guardian

______________________________________________  Date