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Department of Sports Medicine Logan Hall, 2 n d Floor Tuskegee, AL 36088 (334) 724-4545
TUSKEGEE UNIVERSITY ATHLETICS DOCUMENTS NEEDED FOR PROSPECTIVE STUDENTATHLETES/TRYOUTS: NON-ENROLLED & ENROLLED Coaches: 1) Prior to Tryouts, please provide Compliance with the names of the student trying out to ensure that they are academically eligible. * No Student that signed an NLI can participate in the tryout, because they are already legally bound to your program( unless upon enrollment, they do not meet the academic requirements of a Qualifier. 17.02.14 Tryouts—Enrolled Student. A member institution may conduct a tryout of a full-time student currently enrolled at the institution only on its campus or at a site at which the institution normally conducts practice or competition during the regular academic year. (See Bylaw 13.11.2.1 for tryout regulations of a prospective student-athlete.) The following conditions shall apply to a tryout of an enrolled student: (Adopted: 1/13/98 effective 8/1/98, Revised: 1/14/02, 5/13/11, 7/23/13, 4/15/14)
(A) One-Tryout Limitation. No more than one tryout per student per sport shall be permitted during any academic year; VERY IMPORTANT (SPORTS MEDICINE DOCUMENTS): (B) Health and Safety Requirements—Medical Examination and Sickle Cell Solubility Test (SST). (1) Prior to participation in a tryout, a student is required to undergo a medical examination or evaluation administered or supervised by a physician (e.g., family physician, physician of choice). The examination or evaluation must be administered within six months prior to participation in the tryout. The medical examination or evaluation may be conducted by an Orthopedic physician or General Medicine physician. (2) The examination or evaluation shall include a Sickle Cell Solubility Test (SST), unless documented results of a prior test are provided to the institution or the student declines the test and signs a written release (release form is required for everyone). (3) A copy of the student’s personal health insurance card front and back must also accompany the above documents. (4) A tryout release of personal injury/damage form must be signed and dated as well. All paperwork must be completed and turned in to the Sports Medicine staff prior to participation in any tryout for clearance to participate. If there are any concerns in reference to the Sports Medicine paperwork needed prior to any participant trying out, please let me know.
Regards, LaJoy Paige Director of Sports Medicine
EFFECTIVE YEAR: 2015-2016
Name_________________ Sport________
TUSKEGEE UNIVERSITY WALK-ON TRYOUTS/EVALUATIONS RELEASE FOR PERSONAL INJURY AND DAMAGE All physical activity has risks that may range from a fall, to muscle and ligament damage, to circulatory or heart disorders. Consequently, you must be sure that your health is adequate to participate in the strenuous, vigorous physical activity involved in athletic summer camp. It is your responsibility to check with the physician of your choice about your health status and if there is any question regarding your fitness for participation. If you, at any time during participation, experience any distress or have any questions regarding your participation, notify your coach or athletic trainer. Tuskegee University provides no athletic accident insurance for tryouts. YOU MUST PROVIDE YOUR OWN COVERAGE/HEALTH INSURANCE. WHEREAS the undersigned voluntarily desires to participate in a Tuskegee University athletic walk-on tryout/evaluation; and WHEREAS the undersigned is duly aware of the risks and hazards that may arise through participation in said activity and that participation in said activity may result in loss of life, limb, property, or all three, of the undersigned. THEREFORE, it is agreed as follows: THAT in consideration of being allowed to participate in said activity, the undersigned hereby voluntarily assumes all risks and accident or damage to his/her person or property and all risks of liability or demands any kind sustained, whether caused by negligence of Tuskegee University agents or employees, or otherwise; and THE undersigned further voluntarily agrees that the above release shall be binding upon their heirs, administrators, executors, and assigns, of the undersigned; and THE undersigned hereby affirms having accident insurance coverage and having adequate health status to participate in strenuous physical activity. The undersigned further acknowledges that the undersigned has the right to refuse to attempt, or to withdraw from physical activity for any reason. The undersigned accepts the responsibility to report any injury, distress, preexisting condition that may impair performance, or other problems to the coach or the athletic trainer. THE undersigned, by signing this release, hereby certifies that the undersigned has read and fully understands and agrees with the conditions herein provided.
Name:______________________________________ Date of Birth:_______________________ (Print) Name:______________________________________ Date:_______________________ (Participant’s Signature) Parent/Guardian Signature (if under 19):____________________________________________
Tuskegee University Sickle Cell Trait Statement for Prospective Student Athletes-Tryouts 2015-2016 □ I have read and understand the NCAA Sickle Cell Trait Fact Sheet. □ As a prospective student-athlete at Tuskegee University, I am aware I have options with regard to Sickle Cell Solubility testing. I am also aware that I must fully exercise one of these options prior to participating in any structured athletic activities on Tuskegee University’s campus. Option #1: I am aware of my Sickle Cell Trait status and will provide Tuskegee University and its Sports Medicine Staff with documentation of the results. Option #2: I am unaware of my Sickle Cell Trait status. I will however arrange to have my status assessed at my own expense prior to my tryout date at Tuskegee University. I will provide the University’s Medicine Staff with documentation of my results upon reporting to tryouts. Option #3: I am unaware of my Sickle Cell Trait status. I am also fully aware of the risks inherent in athletics participation by those with the Sickle Cell Trait. With this knowledge, I hereby decline the testing and waive my right to obtain such testing. I have read and fully understand the options provided me with regard to Sickle Cell Trait solubility testing. I am indicating which option I choose to exercise by circling the option below, signing, and returning this document to Tuskegee University’s Sports Medicine Staff upon reporting to tryouts.
Option #1
Signature of Student-Athlete
Printed name of Student-Athlete
Option #2
Option #3
Date
Department of Sports Medicine Logan Hall, 2 n d Floor Tuskegee, AL 36088 (334) 724-4545
TUSKEGEE UNIVERSITY ATHLETICS DOCUMENTS NEEDED FOR PROSPECTIVE STUDENTATHLETES/TRYOUTS: NON-ENROLLED & ENROLLED Coaches: 1) Prior to Tryouts, please provide Compliance with the names of the student trying out to ensure that they are academically eligible. * No Student that signed an NLI can participate in the tryout, because they are already legally bound to your program( unless upon enrollment, they do not meet the academic requirements of a Qualifier. 17.02.14 Tryouts—Enrolled Student. A member institution may conduct a tryout of a full-time student currently enrolled at the institution only on its campus or at a site at which the institution normally conducts practice or competition during the regular academic year. (See Bylaw 13.11.2.1 for tryout regulations of a prospective student-athlete.) The following conditions shall apply to a tryout of an enrolled student: (Adopted: 1/13/98 effective 8/1/98, Revised: 1/14/02, 5/13/11, 7/23/13, 4/15/14)
(A) One-Tryout Limitation. No more than one tryout per student per sport shall be permitted during any academic year; VERY IMPORTANT (SPORTS MEDICINE DOCUMENTS): (B) Health and Safety Requirements—Medical Examination and Sickle Cell Solubility Test (SST). (1) Prior to participation in a tryout, a student is required to undergo a medical examination or evaluation administered or supervised by a physician (e.g., family physician, physician of choice). The examination or evaluation must be administered within six months prior to participation in the tryout. The medical examination or evaluation may be conducted by an Orthopedic physician or General Medicine physician. (2) The examination or evaluation shall include a Sickle Cell Solubility Test (SST), unless documented results of a prior test are provided to the institution or the student declines the test and signs a written release (release form is required for everyone). (3) A copy of the student’s personal health insurance card front and back must also accompany the above documents. (4) A tryout release of personal injury/damage form must be signed and dated as well. All paperwork must be completed and turned in to the Sports Medicine staff prior to participation in any tryout for clearance to participate. If there are any concerns in reference to the Sports Medicine paperwork needed prior to any participant trying out, please let me know.
Regards, LaJoy Paige Director of Sports Medicine
EFFECTIVE YEAR: 2015-2016
Name_________________ Sport________
TUSKEGEE UNIVERSITY WALK-ON TRYOUTS/EVALUATIONS RELEASE FOR PERSONAL INJURY AND DAMAGE All physical activity has risks that may range from a fall, to muscle and ligament damage, to circulatory or heart disorders. Consequently, you must be sure that your health is adequate to participate in the strenuous, vigorous physical activity involved in athletic summer camp. It is your responsibility to check with the physician of your choice about your health status and if there is any question regarding your fitness for participation. If you, at any time during participation, experience any distress or have any questions regarding your participation, notify your coach or athletic trainer. Tuskegee University provides no athletic accident insurance for tryouts. YOU MUST PROVIDE YOUR OWN COVERAGE/HEALTH INSURANCE. WHEREAS the undersigned voluntarily desires to participate in a Tuskegee University athletic walk-on tryout/evaluation; and WHEREAS the undersigned is duly aware of the risks and hazards that may arise through participation in said activity and that participation in said activity may result in loss of life, limb, property, or all three, of the undersigned. THEREFORE, it is agreed as follows: THAT in consideration of being allowed to participate in said activity, the undersigned hereby voluntarily assumes all risks and accident or damage to his/her person or property and all risks of liability or demands any kind sustained, whether caused by negligence of Tuskegee University agents or employees, or otherwise; and THE undersigned further voluntarily agrees that the above release shall be binding upon their heirs, administrators, executors, and assigns, of the undersigned; and THE undersigned hereby affirms having accident insurance coverage and having adequate health status to participate in strenuous physical activity. The undersigned further acknowledges that the undersigned has the right to refuse to attempt, or to withdraw from physical activity for any reason. The undersigned accepts the responsibility to report any injury, distress, preexisting condition that may impair performance, or other problems to the coach or the athletic trainer. THE undersigned, by signing this release, hereby certifies that the undersigned has read and fully understands and agrees with the conditions herein provided.
Name:______________________________________ Date of Birth:_______________________ (Print) Name:______________________________________ Date:_______________________ (Participant’s Signature) Parent/Guardian Signature (if under 19):____________________________________________
Tuskegee University Sickle Cell Trait Statement for Prospective Student Athletes-Tryouts 2015-2016 □ I have read and understand the NCAA Sickle Cell Trait Fact Sheet. □ As a prospective student-athlete at Tuskegee University, I am aware I have options with regard to Sickle Cell Solubility testing. I am also aware that I must fully exercise one of these options prior to participating in any structured athletic activities on Tuskegee University’s campus. Option #1: I am aware of my Sickle Cell Trait status and will provide Tuskegee University and its Sports Medicine Staff with documentation of the results. Option #2: I am unaware of my Sickle Cell Trait status. I will however arrange to have my status assessed at my own expense prior to my tryout date at Tuskegee University. I will provide the University’s Medicine Staff with documentation of my results upon reporting to tryouts. Option #3: I am unaware of my Sickle Cell Trait status. I am also fully aware of the risks inherent in athletics participation by those with the Sickle Cell Trait. With this knowledge, I hereby decline the testing and waive my right to obtain such testing. I have read and fully understand the options provided me with regard to Sickle Cell Trait solubility testing. I am indicating which option I choose to exercise by circling the option below, signing, and returning this document to Tuskegee University’s Sports Medicine Staff upon reporting to tryouts.
Option #1
Signature of Student-Athlete
Printed name of Student-Athlete
Option #2
Option #3
Date
