This Athletic Participation Packet must be completed with a parent or legal guardian present.
Students are not permitted to complete this packet alone unless they have reached 18 years of age prior to the beginning of the sport they are participating in.

By continuing, you acknowledge and agree that:
• The information in this packet has been reviewed together by the student and their parent/guardian.
• All signatures and acknowledgments provided in this form are truthful and completed by the appropriate party.
• The parent/guardian understands the information, policies, and expectations described in this packet.

Submitting this form serves as your electronic signature under applicable laws (e.g., ESIGN, UETA, and California’s Electronic Transactions Act).
Falsifying information may result in delays to athletic clearance.

The following student-athlete is applying to participate in GTA Schools(Griffin Academy or MIT Academy) athletic programs:

Available HS Sports 2026-27

MIT: Boys Soccer, Girls Flag Football, Girls Volleyball, Boys Basketball, Girls Basketball, Baseball, Boys Volleyball, Girls Soccer

Griffin: Boys Soccer, Girls Volleyball, Boys Basketball, Boys Volleyball, Girls Soccer

 

GTA Athletic Department Agreement For Student Athlete and Parent/Guardian Regarding Use of Steroids and Acknowledgment of GTA Student Handbook

As a condition of membership in the California Interscholastic Federation (CIF), the GTA Athletic Department is prohibiting the use and abuse of androgenic/anabolic steroids. CIF Bylaw 524 requires that all participating students and their parents/ guardians sign an agreement.

By signing the Emergency/Participation Form, we agree that the student shall not use androgenic/anabolic steroids without the written prescription of a fully licensed physician, as recognized by the American Medical Association, to treat a medical condition.

We recognize that under CIF Bylaw 200 D the student may be subject to penalties, including ineligibility for any CIF competition, if the student or his/her parents/guardian provides false or fraudulent information to the CIF. We understand that the student's violation of the district's policy regarding steroids may result in discipline against him/her, including, but not limited to, restriction from athletics, suspension, or expulsion. By signing this form, I acknowledge that I have read and understand the GTA Student Athlete/Parent Handbook.

Name of Student:

{studentName101}

Parent/Guardian's Printed FIRST AND LAST NAME

{parentguardianPrinted}

INFORMED CONSENT, WAIVER OF LIABILITY, AND ACKNOWLEDGMENT

FOR VOLUNTARY ATHLETIC ACTIVITIES

By their very nature, athletic activities can put students in situations in which SERIOUS, CATASTROPHIC and perhaps FATAL injuries may occur. These injuries could include, but are not limited to the following: death, paralysis, brain damage, serious injury to internal organs, bones, joints, ligaments, muscles, tendons, eyes, other aspects of the skeletal system and potential impairment to general health, well-being and physical appearance. Students and parents must assess the risks involved in such participation and make their choice to participate in spite of those risks. No amount of instruction, precaution, or supervision will eliminate all risk of injury. By granting permission for your child to participate in athletic activities, you, the parent/legal guardian, acknowledge that such risk exists. Just as driving an automobile involves a choice of risk; participation in athletics is inherently dangerous. The obligation of parents and students in making this choice to participate cannot be overstated. By granting permission for your child to participate in athletic competition, the parent/guardian acknowledges that playing or practicing in any sport can be a dangerous activity involving MANY RISKS OF INJURY. Further, because of the dangers of participating in athletics, parent and athlete recognize the importance of following coaches' instructions regarding playing techniques, training, equipment, nutrition, team rules, etc. both in competition and practice and agree to obey such instructions. All participants in this activity should understand that participation is voluntary and is not required by the school. If any of the foregoing is not completely understood and you have questions, please contact your school athletic director or school administrator for further information. Parents & Guardians, Please Note: Section 35330 of the California Education Code states in part: "All persons making the field trip or excursion shall be deemed to have waived all claims against the district, a charter school, or the State of California for injury, accident, illness, or death occurring during or by reason of the field trip or excursion." Athletic activities to and from places are considered field trips. The undersigned has read and hereby agrees to hold GTA Schools, its employees, agents, authorizer(s), volunteers and/or sponsors and any other person, firm or corporation charged or chargeable with responsibility or liability, free and harmless from any and all claims, demands, damages, costs, expenses, loss of services, action and causes of action resulting from the use of facilities, equipment, and participation by child in the above named athletic activity, to the fullest extent of the law. I have read and understand the material contained in this form and hereby authorize my child to participate in GTA Schools' Athletics Program.

Name of Student:

{studentName101}

Parent/Guardian's Printed FIRST AND LAST NAME

{parentguardianPrinted}

ATHLETICS EMERGENCY INFORMATION

Name of Student:

{studentName101}

Parent/Guardian's Printed FIRST AND LAST NAME

{parentguardianPrinted}

In an emergency, if the parent/ guardian cannot be reached, please notify:

IMPORTANT: I am not aware of any medical condition that would render it inappropriate for my child participate in athletics. In the event that I cannot be reached in an emergency, I hereby give permission to the physician selected by the coach or school staff to secure proper treatment for my child. Permission is hereby granted to the attending physician to proceed with any major or minor surgical treatment, X- ray examination, and immunizations for the above student. In the event of an emergency arising out of a serious illness, the need for major surgery, or significant accidental injury, I understand that an attempt will be made by the attending physician to contact me in the most expeditious way possible. If the physician is not able to communicate with me, the treatment necessary for the best interest of the above-named student may be given. I also agree that in the event that my child is inured as a result participation in this activity, whether or not caused by the negligence (active or passive) of the school personnel, recourse for the payment of any resulting hospital, medical, or related costs and expenses will first be had against any accident, hospital, or medical insurance or any benefit plan of mine or my spouse.

Parent/Guardian's Printed FIRST AND LAST NAME

{parentguardianPrinted}

GTA Parent
Code of Conduct
Agreement

 

As the Parent/Guardian of a GTA Student Athlete, I will:

• Encourage good sportsmanship by demonstrating support for all players, coaches, and officials at every game.
• Demand a sports environment free of drugs, tobacco, cannabis, and alcohol at events
• Remember that the games are for the kids.
• Remain in the spectator area and not approach the team during game time (this includes pregame, halftime, and postgame) unless in the event of an emergency.
• Be responsible for the behavior of any guests that accompany me to support my student.
• NOT be negative towards game officials. I understand the following actions will occur if myself or my guests do not honor this agreement:

1.    I will be asked to leave the event, suspended for the following game, and will be required to complete the NFHS Sportsmanship Course

2.    I will be expelled from all school events for the remainder of the year and possibly the following.

• Treat opposing players, coaches, officials and volunteers with respect.
• Communicate my concerns through the proper channels in a dignified manner
• Observe the 24 hour rule as stated in the GTA Athletic Department Handbook regarding playing time and other concerns.

 

 

Parent/Guardian's Printed FIRST AND LAST NAME

{parentguardianPrinted}

 

Why am I getting this information sheet?

You are receiving this information sheet about concussions because of California state law AB 25 (effective January 1, 2012), now Education Code § 49475:

1. The law requires a student-athlete who may have a concussion during a practice or game to be removed from the activity for the remainder of the day. 2. Any student-athlete removed for this reason must receive a written note from a physician trained in the management of concussion before returning to practice. 3.Before a student-athlete can start the season and begin practice in a sport, a concussion information sheet must be signed and returned to the school by the student-athlete and the parent or guardian.

Every 2 years all coaches are required to receive training about concussions (AB 1451), as well as certification in First Aid training, CPR, and AEDs (life-saving electrical devices that can be used during

What is a concussion and how would I recognize one?

A concussion is a kind of brain injury. It can be caused by a bump or hit to the head, or by a blow to another part of the body with the force that shakes the head. Concussions can appear in any sport, and can look differently in each person.

Most concussions get better with rest and over 90% of athletes fully recover. However, all concussions should be considered serious. If not recognized and managed the right way, they may result in problems including brain damage and even death.

Most concussions occur without being knocked out. Signs and symptoms of concussion (see back of this page) may show up right after the injury or can take hours to appear. If your child reports any symptoms of concussion or if you notice some symptoms and signs, seek medical evaluation from your team's athletic trainer and a physician trained in the evaluation and management of concussion. If your child is vomiting, has a severe headache, or is having difficulty staying awake or answering simple questions, call 911 for immediate transport to the emergency department of your local hospital. On the CIF website is a Graded Concussion Symptom Checklist. If your child fills this out after having had a concussion, it helps the physician, athletic trainer or coach understand how they are feeling and hopefully will show improvement over time. You may have your child fill out the checklist at the start of the season even before a concussion has occurred so that we can understand if some symptoms such as headache might be a part of their everyday life. We call this a "baseline" so that we know what symptoms are normal and common for your child. Keep a copy for your records, and turn in the original. If a concussion occurs, your child can fill out this checklist again. This Graded Symptom Checklist provides a list of symptoms to compare over time to follow your child's recovery from the concussion.

What can happen if my child keeps playing with concussion symptoms or returns too soon after getting a concussion?

Athletes with the signs and symptoms of concussion should be removed from play immediately. There is NO same day return to play for a youth with a suspected concussion. Youth athletes may take more time to recover from concussion and are more prone to long-term serious problems from a concussion.

Even though a traditional brain scan (e.g., MRI or CT) may be "normal", the brain has still been injured.

Animal and human research studies show that a second blow before the brain has recovered can result in serious damage to the brain. If your athlete suffers another concussion before completely recovering from the first one, this can lead to prolonged recovery (weeks to months), or even to severe brain swelling (Second Impact Syndrome) with devastating consequences. There is an increasing concern that head impact exposure and recurrent concussions may contribute to long-term neurological problems. One goal of concussion education is to prevent a too early return to play so that serious brain damage can be prevented.

Signs observed by teammates, parents and coaches include:

Looks dizzy Looks spaced out Confused about plays Forgets plays Is unsure of game, score, or opponent Moves clumsily or awkwardly Answers questions slowly

Slurred speech Shows a change in personality or way of acting Can't recall events before or after the injury Seizures or "has a fit" Any change in typical behavior or personality Passes out

Symptoms may include one or more of the following:

Nausea or throws up Neck pain Has trouble standing or walking Blurred, double, or fuzzy vision Bothered by light or noise Feeling sluggish or slowed down Feeling foggy or groggy Drowsiness Change in sleep patterns

Loss of memory "Don't feel right" Tired or low energy Sadness Nervousness or feeling on edge Irritability More emotional

Concentration or memory problems Repeating the same question/comment

What is Return to Learn?

Following a concussion, students may have difficulties with short- and long-term memory, concentration and organization. They will require rest while recovering from injury (e.g., avoid or limit reading, texting, video games, loud movies), or may even need to limit school attendance for a few days. As they return to school, the schedule might need to start with a few classes or a half-day. If recovery from a concussion is taking longer than expected, they may also benefit from a reduced class schedule and/or limited homework; a formal school assessment may also be necessary. Your school or physician can help suggest and make these changes. Students should complete the Return to Learn guidelines and return to complete school before beginning Return to Play, unless your physician makes other recommendations. Go to the CIF website (cifstate.org for more information on Return to Learn.

How is Return to Play (RTP) determined?

Concussion symptoms should be completely gone before returning to competition. A RTP progression is a gradual, step-wise increase in physical effort, sports-specific activities and then finally unrestricted activities. If symptoms occur with activity, the progression should be stopped. If there are no symptoms the next day, exercise can be restarted at the previous stage.

RTP after concussion should occur only with medical clearance from a physician trained in the evaluation and management of concussions, and a step-wise progression program monitored by an athletic trainer, coach, or other

identified school administrator. Please see cifstate.org for a graduated return to play plan. [AB 2127, a California state law effective 1/1/15, states that return to play (i.e., full competition) must be no sooner than 7 days after the concussion diagnosis has been made by a physician.]

Final Thoughts for Parents and Guardians:

It is well known that students will often not talk about signs of concussions, which is why this information sheet is so important to review with them. Teach your child to tell the coaching staff if they experience such symptoms, or if they suspect that a teammate has had a concussion. You should also feel comfortable talking to the coaches or athletic trainer about possible concussion signs and symptoms that you may be seeing in your child.

References: American Medical Society for Sports Medicine position statement: concussion in sport (2013) Consensus statement on concussion in sport: the 5th International Conference on Concussion in Sport held in Berlin, October 2016 http://www.cdc.gov/concussion/HeadsUp/youth.html

You are receiving this information sheet about concussions because of California state law AB 25 (effective January 1, 2012), now Education Code § 49475:

1. The law requires a student-athlete who may have a concussion during a practice or game to be removed from the activity for the remainder of the day. 2. Any student-athlete removed for this reason must receive a written note from a medical doctor trained in the management of concussion before returning to practice. 3.Before a student-athlete can start the season and begin practice in a sport, a concussion information sheet must be signed and returned to the school by the student-athlete and the parent or guardian.

Every 2 years all coaches are required to receive training about concussions (AB 1451), as well as certification in First Aid training, CPR, and AEDs (life-saving electrical devices that can be used during CPR

For current and up-to-date information on concussions you can visit: http://www.cdc.gov/concussion/HeadsUp/youth.html

I acknowledge that I have received and read the CIF Concussion Information Sheet.

Name of Student:

{studentName101}

Parent/Guardian's Printed FIRST AND LAST NAME

{parentguardianPrinted}

California Department of Education Updated April 2020

Parent/Guardian and Pupil Sudden Cardiac Arrest Warning Signs and Symptoms Information and Acknowledgment Form

On July 1, 2017, Assembly Bill 1639, known as the Eric Paredes Sudden Cardiac Arrest (SCA) Prevention Act went into effect. This requires the pupil and their parent or guardian to read, sign, and return an SCA form of acknowledgment before the pupil participates in any athletic activity. Districts may use this form, a form located on the California Interscholastic Association (CIF) website, or design their own form. An SCA acknowledgment form must be signed and returned to the school site each school year. On August 30, 2019, Assembly Bill 379 also added sudden cardiac arrest prevention requirements to the Health and Safety Code for youth sports organizations. The amended Health and Safety Code, Division 106, Article 2.5: now includes, Youth Sports Concussion and Sudden Cardiac Arrest Prevention Protocols [124235-124236].

What Is SCA? SCA occurs suddenly and often without warning. It is triggered by an electrical malfunction in the heart that causes an irregular heartbeat. With the heart's pumping action disrupted, the heart cannot pump blood to the brain, lungs, and other organs. Seconds later, a person loses consciousness and has no pulse. Death occurs within minutes if the victim does not receive treatment. Who Is at Risk for SCA? Thousands of sudden cardiac arrests occur among youth each year, as it contributes to the #2 medical cause of death of youth under the age of 25 and is the #1 cause of death of student athletes during exercise. While a heart condition may have no warning signs, studies show that many young people do have warning signs or symptoms but neglect to tell an adult. This may be because they are embarrassed, they do not want to jeopardize their playing time, they mistakenly think that they are out of shape and need to train harder, or they simply ignore the symptoms, hoping the signs will go away.

Possible Warning Signs and Risk Factors

Fainting or seizure, especially during or right after exercise Fainting repeatedly or with excitement or startle Excessive shortness of breath during exercise Racing or fluttering heart palpitations or irregular heartbeat Repeated dizziness or lightheadedness Chest pain or discomfort with exercise Excessive, unexpected fatigue during or after exercise

A pupil who faints during or following participation in an athletic activity must be removed from play and may not return to play until they are evaluated and cleared by a physician and surgeon, nurse practitioner or physician's assistant. I have reviewed and understand the symptoms, warning signs, and risk factors associated with SCA.

Name of Student:

{studentName101}

Parent/Guardian's Printed FIRST AND LAST NAME

{parentguardianPrinted}

Opioid Fact Sheet Acknowlegment Page

I acknowledge that I have received and read the foregoing Opioid Fact Sheet for Patients.

Name of Student:

{studentName101}

Parent/Guardian's Printed FIRST AND LAST NAME

{parentguardianPrinted}

 

CIF HEAT ILLNESS ACKNOWLEDGEMENT PAGE

I acknowledge that I have received and read the CIF Heat Illness Information Sheet.

Name of Student:

{studentName101}

Parent/Guardian's Printed FIRST AND LAST NAME

{parentguardianPrinted}