Knox Doss Middle School

at Drakes Creek

Cheerleading

   

   

 

 

 

Policies and Guidelines

2009-2010

 

 

 

 

 

 

 

 

 

 

Knox Doss Middle School at Drakes Creek

Cheerleading Purpose Statement

 

 

       The purpose of the cheerleaders is to support the extracurricular activities of Knox Doss Middle School at Drakes Creek by promoting school spirit. Being a cheerleader is an honor and special privilege. A CheerleaderŐs first responsibility is to her academic program. The educational process should not be compromised by participating in cheerleading. Cheerleaders exist to promote good sportsmanship, good citizenship, and wholesome and enthusiastic school spirit. Cheerleaders are first and foremost representatives and ambassadors of their school. Because of these special responsibilities, members of the cheerleading squad are expected to maintain high standards of behavior, both on and off campus.

 

       Being the most visible and recognizable representative of a school, cheerleaders are in a position of great influence; therefore, high standards of conduct are essential. Positive personal behavior and squad cohesiveness demonstrate these standards. Appropriate behavior will help earn the respect of the student body and is the core of developing effective school spirit and student involvement.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Tryout Qualifications and Eligibility Requirements

1.    A student must attend Knox Doss Middle School at Drakes Creek in accordance with the state and county requirements.

2.    A student must have an overall average of 75 or above. This will be calculated by using report card grades in all courses for the current school year, as of the last grading period.

3.    A student may not have incurred any disciplinary infraction that leads to a suspension (ISS or OSS) from school during the present school year.

4.    A student must present proof of medical insurance.

 

 

Ineligibility Reasons

1.    Any student who is presently aware of the fact that he/she are definitely moving during the school year.

2.    Any student who has been unable to take physical education for chronic medical reasons.

3.    Any student who has conflicting interests such as dance classes, gymnastics, or athletics, and who cannot verify in writing that cheerleading responsibilities can be carried out in addition to other outside activities. 

4.    Any student who quits the squad by his/her own choice or was permanently removed from the squad may not try out again during the following school year.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pre-tryout Procedures

The candidate and/or a parent or guardian of each of the candidates must attend a mandatory pre-tryout parentŐs meeting. This meeting is to fully inform the parent/guardian of the requirements, responsibilities, expenses, and procedures involved in cheerleading. The parent or guardian must sign a permission form authorizing his/her child to participate in tryouts, and if selected, all activities involved with cheerleading.

 

 

**All tryout paperwork must be turned in to the coach(es) by April 27, 2009.

1. Agreement to cheerleading procedures and guidelines signed by parent and student.

2. Proof of insurance

3. Physical examination form 

4. Parent authorization of consent to treatment of student 

5. Copy of last report card

6. (3) Three recommendations from school faculty members of current school.

 

All applicants earning a position on the Cheerleading Squad for the next school year must continue to meet all the above stated Ňrequired qualifications to tryoutÓ for the remainder of their present school year. Failure to meet these requirements will result in immediate forfeiture of their position on the Cheerleading Squad. Please note:  loss of position on the squad will result in forfeit of any funds and/or monies collected from the squad member/parent for cheerleading activities, including uniform components.

 

Pre-Tryout Clinic

á  Prior to judging, candidate will attend a mandatory 3-day clinic to practice skills/techniques.

á  Spectators (including parents, friends, and non-involved school personnel) are not permitted to watch or videotape clinic practices or tryouts.

á  Candidates should wear proper cheerleading attire – t-shirt, cheer shorts, and tennis shoes. Hair should be worn up in a ponytail away from the face and all jewelry removed.

á  Candidates will learn a cheer and a dance routine.

á  Tryout numbers are drawn on the last day of practice.

 

**Should your child make cheerleading, there will be a Mandatory meeting on Sunday May 3rd from 2:00 – 4:30 p.m. in the Beech High School Annex cafeteria.  Students will be fitted for uniforms, camp clothes, shoes, etc. from 2:00 – 4:00 p.m. Beginning at 4:00, we will have a parent meeting where we will discuss gymnastics, camp, fundraising, payments, as well as any questions you have.  Please bring your checkbook.

 

Tryout Procedures

 

á   The Knox Doss / Drakes Creek Middle School Cheerleading Squad will consist of a minimum of eight to a maximum of twelve cheerleaders.

á   The judges may call back any individual or group at their discretion.

á   The eight to twelve girls will consist of four to six eighth grade girls and four to six seventh grade girls.

á   The 2009 – 2010 cheerleaders will be posted on the front door of the Beech High School Annex at 7:00 p.m. on the night of the tryouts.  A roster will also be posted on the KDMS website.

á   The tryout process is organized and facilitated by the cheerleading coach. In addition to the judges, the coaches and up to three designated faculty members are present in the tryout room for the purpose of giving direction, transporting score sheets from judges to tally station, etc. At least one administrator is present in the tryout room to oversee the selection process. Candidates are in the tryout center for the length of their performance only.

á   Tryouts are CLOSED to everyone except coaches, judges, candidates, and assistants. 

á   Students MUST BE PRESENT at tryouts in order to be eligible for selection. Students must attend school on the day of tryouts in order to participate in the after-school judging.

á   Candidates will tryout in groups of three.

á   Candidates are assigned a participant number prior to tryouts. During the judging and tabulation of scores students are referred to by number only.

á   Candidates should wear a plain white shirt, black or dark blue shorts, and tennis shoes. No visible logos are allowed on any of the clothing. Hair should be worn up in a ponytail and all jewelry should be removed.

á   A minimum of three impartial judges will be obtained. Judges shall not be a relative of any candidate or a private coach of any candidate. Judges will not be school employees.

á   Candidates perform before the judges individually and in previously assigned small groups.  

á   The judgesŐ evaluations will be based on general appearance, personality, projection/spirit, physical ability (splits/jumps), ability to execute cheers, coordination, enthusiasm, and stamina. *see attached score sheet

á   The judges will make final squad selections. Selection will be based on a composite of the judgesŐ evaluations, participantsŐ grades, attitude, teacher recommendations, and observations by the coach(es) during the tryout period.  

á  All candidates and/or any person acting as a representative on their behalf are prohibited from having any form of communication or personal contact with any of the judges prior to, during, or after the tryout process. Violation of this guideline will result in the immediate removal of the candidate from the process and/or squad if the candidate has been selected. Judges are instructed to report any incident of the activity to the administrator. The decision of the coaches and the principal is final in all tryout results.

            JudgeŐs Signature: ____________________________________ date: ____________

            Squad: ___________________________________ Candidate number: __________

 

JudgeŐs Total  ________ / 50

 

 

 

Comments: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Cheerleading Tryouts Judging Sheet

Text Box: Category Possible Points Points Gymnastic Skills 10 ________ Jumps 10 ________ Communication Skills Voice, facial expression, confidence 10 ________ Motion Technique Arm levels, sharp motions, correct fists 10 ________ Dance Technique Sharp motions, keeps beat, expression 10 ________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

KNOX DOSS MIDDLE SCHOOL at Drakes Creek CHEERLEADER AGREEMENT

 

The responsibilities described in this section and consequences for failure to meet responsibilities listed in the next section take effect at the time the selected

cheerleaders are announced.

 

 

A. SCHOLASTIC

1. A prospective cheerleader must pass 4 out of 5 academic subjects in the semester prior to the cheering season.

2. CheerleadersŐ grades will be checked every 4 1Ú2 weeks using their progress report and report card. Any cheerleader who does not keep a passing grade in each subject will have a disciplinary hearing with the principal, coach, athletic director, and parent to determine appropriate action. If an average of 70 is not maintained per class, the cheerleader will be encouraged to seek tutoring. Demerits will be assigned for DŐs and FŐs. See ŇDemerit System.Ó

 

 

B. SUSPENSION AND DISMISSAL

1. Breaking a school rule and regulation to the extent that serious disciplinary action is exercised

         through the PrincipalŐs office.

2. The use of profanity or foul language while in uniform or on school business, abusive language

         used toward members of the squad or school.

3. Cheerleaders may be dismissed for the possession or use of smoking materials, alcoholic beverages, or illegal drugs at any time.

4. The coach and/or principal have the right to remove a cheerleader from the squad for serious infractions of school rules.

5. The cheerleader will be subject to a Demerit System for behavior and rule infractions, which could result in suspension or dismissal from the squad. See ŇDemerit System.Ó

6. The cheerleader will be benched if they are late on payment of required costs. See ŇPayment Schedule.Ó

 

 *For all disciplinary reasons, a hearing will be held between the principal, the coach, and the

member who may be involved in actions that violate the tenure of this agreement.

 

 

C. UNIFORMS

1. KDMS provides a uniform for each Cheerleader. Cheerleaders will use uniforms on a yearly basis. If uniforms are not returned or are returned in disrepair, the cheerleader will be responsible for paying to replace the uniform.  

2. It is the responsibility of each individual to purchase accessories including items such as shoes, bloomers, midriff bodysuit, camp clothes, warm-ups, etc. 

3. Uniforms will be worn to school only on home game days and on any special spirit days as designated by the principal or coach.

4.Corsages are not permitted on uniforms while cheering.

5.Uniforms must be worn correctly as directed by the coach.

 

 

 

 

 

D. TRANSPORTATION

1. The cheerleader is responsible for getting to and from all home games and designated away games.

2. Because traffic can be unpredictable, please leave early enough for away games as traffic jams could cause long delays.

 

 

E. GAME EXPECTATIONS 

1. Cheerleaders are not allowed to use CELL PHONES during a game.

2. Cheerleaders must arrive at the game 30 minutes prior to game time dressed and ready for warm-up.

3. Cheerleaders must be in the correct uniform including hair, bloomers, socks, and shoes or they will be benched.

4. Cheerleader must stand in ready position between cheers.

5. NO stunting will be permitted unless the coach is present.

6. Do not take food or drinks to the cheering area.(water only)

7. Do not leave food containers, drink cans, or any trash in the stands.

8. Cheerleaders must stand at attention during the playing of the National Anthem.

9. No talking between yourselves or to others during the game.

10.  NO CHEWING GUM!

11.  No jewelry! This is a TSSAA rule!

12.  Cheerleaders must be on the floor in ready position one minute prior to the buzzer.

13.  Cheerleaders will show good sportsmanship at all times whether we win or lose.

14.  Cheerleaders will be friendly and hospitable to visiting cheerleaders, fans and team members.

15.  No display of affection at ANY time while in uniform.

16.  NEVER leave the game without permission from the coach or supervisor.

17.  Being benched means:  Cheerleader must sit with coach during the entire game. No socializing, visiting, eating, and no homework done during that time. NO USE of CELL PHONES.

 

 

F.  SQUAD EXPECTATIONS

1. At all times, in uniform or not, the cheerleader must be a good, moral representative of KDMS. There will be no cursing, inappropriate use of cell phones, or immodest dress. A cheerleader who has detention or ISS may be asked to run laps.

2. A positive attitude is necessary on the part of any school leader. Any demonstration of discontent or refusal to fully participate in practice sessions and game situations will result in suspension. The coach will determine suspension length. Cheerleaders must attend all scheduled practices and games.

3. The discipline and drug policy developed by the school must be followed. 

4. A physical by a certified physician and a medical treatment and liability release must be on file.

5. The cheerleader must have health insurance.  

6. A cheerleader must be present at school the entire day of a game in order to cheer that night. If you are to be absent, it can only be for a half day and it must be excused by the school. (Example – doctors appointment)  If an extenuating circumstance arises, the coach/principal will make a decision.

7. Any cheerleader who cannot get along with the remainder of the squad will be counseled with and if the problem persists, a meeting will be held with the cheerleader, coach, and principal. If a second meeting is necessary, the cheerleader may be removed from the squad.

8. Cheerleaders must perform any duties assigned by the coach and captains, such as fundraising, sign making, spirit building, etc.

9. No jewelry can be worn while participating in cheerleading activities - this includes all games, practices, fund raising, etc. (This is a county and TSSAA policy)

 

F.  SQUAD EXPECTATIONS (contŐd)

 

 

10.  The coach, athletic director, and the administrator will handle special circumstances not stated in the rules of this contract on an individual basis.

11.  Since cheerleading is an expensive sport, we will do fundraising. Each cheerleader must participate in the fundraiser or you may pay cash for the money you are required to raise. The school will furnish game uniforms for each cheerleader. Other outfits must be furnished by the family of the cheerleader. The cheerleaderŐs family must purchase school jackets, warm-up suits, body suits, socks, hair bows, ankle braces, shoes, and other items.

12.  The cheerleader must be responsible for the care and maintenance of all equipment purchased through the school. Uniforms must be kept clean. The cheerleader must replace any part of the uniform lost or damaged.

13.  Since this is a team sport, if a cheerleader breaks a family rule, being grounded or withholding the cheerleader from a practice/game as punishment will not be excused.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Knox Doss Middle School at Drakes Creek Schedule

2009-2010

 

 

Summer Practice at Prime Tyme:

Beginning May 21, 2009, we will practice on Thursdays from 3:00 – 5:00 p.m.  at Prime Tyme Athletics.  We will not practice June 25 or July 2 due to the TSSAA dead period.  Practices will resume on July 9.

 

 

Cheer Camp Ő09:

This year we will be attending cheer camp at Prime Tyme Athletics on June 3rd through 6th.  We will begin promptly each day at 9:00 a.m. and conclude each afternoon at 3:00 p.m. Lunch will be provided each day at the gym.  Please be sure to bring lots of water!

 

 

Football Season:

We will practice on Mondays and Wednesdays immediately after school until 4:15 or 4:30.  Our practice time at Prime Tyme Athletics is on Thursdays from 3:00 until 5:00. Our games are on Tuesdays at 6:30 p.m. Cheerleaders are required to be at each game site at 5:30 p.m. 

 

 

Basketball Season:

Games are on Mondays and Thursdays starting at 5:30 p.m.  On home game nights, cheerleaders will meet in the gym immediately after school to practice until 3:30.  From practice, we will go back to my classroom for study hall and dinner before the game.  There will be a parent sign-up sheet to bring dinner for each home game.  On away game nights, cheerleaders will meet at the game site at 4:45 p.m.

 

 

**The last week in July and the first week in August there will be practice three days a week for two hours each day.  A schedule of these practices will be given out in June. These practices will be in the school gym (or at Prime Tyme if the gym in not yet available).  These practices are MANDATORY.  For every day a cheerleader misses a practice that will be one game they sit out!

 

 

**Should we do a competition, this does not include practice times for this.

 

 

 

THE TSSAA REQUIRES A MANDATORY DEAD PERIOD – JUNE 22 – JULY 5, 2009 – THERE WILL BE NO PRACTICES DURING THIS TIME.

ESTIMATED CHEERLEADING COSTS FOR 2009-2010

 

 

 

                                                _____________________

                                    Total               $ 537.00

 

 

 

 **PLEASE NOTE:

 1. Fees are nonrefundable.

 2. The above amounts are estimates. 

 3. Cheerleaders will be given opportunities to fund raise their individual costs.

 4. Total does NOT include monthly costs paid to Prime Tyme Athletics.

 

 

 

*PRACTICE @ PRIME TYME ATHLETICS

         $40.00 registration fee, due immediately; 70.00 per month beginning May 21, 2009

 

 

 

Mandatory practices at Prime Tyme Athletics will be one day a week from 3:00 to 5:00 throughout the school year and the summer unless otherwise noted. Accounts with Prime Tyme Athletics must be current in order for the cheerleader to participate at Prime Tyme and at games.

 

 

All practices are mandatory. Unexcused absences from practices will result in being benched. Cheerleader must notify coach of summer vacations in advance in order for them to be excused absences. See ŇDemerit System.Ó

 

 

 

 

 

 

 

 

Knox Doss Middle School at Drakes Creek

Cheerleading Demerit System 2009-2010

 

Offenses not listed may also warrant demerits at the discretion of the coach/sponsor. Once a cheerleader has reached three demerits, he/she will be benched for an entire game. Please see the definition of benched in the cheerleader agreement. The cheerleader must still attend the game dressed in uniform. At her discretion, the coach may choose to have the cheerleader do extra conditioning as a result of demerits instead of being benched. Once extra conditioning or benched time has been served, the demerit is NOT gone from the record. After six demerits, cheerleader will receive a probation letter. If a cheerleader reaches nine demerits, the cheerleader will be removed from the squad, whether or not a probation period has occurred.

 

 

Offense                                                                                                            # of demerits 

1. Not properly dressed for practice (shoes, clothes, etc)                                               1

2. Wearing fingernail polish/ jewelry to games/ practices                                               1

3. Chewing gum during games or practice                                                                   1

4. Moving about, unnecessary talking during game                                                      1

5. Being late to practice                                                                                                2

6. Being late to a game                                                                                                 2

7. Acting silly / unnecessary talking while building or cheering                                    2

8. Showing poor sportsmanship toward squads, teams, fans                                          2-3

9. DŐs on report card                                                                                                   1

10. FŐs on report card                                                                                                              2

11. Showing up for a game in incorrect uniform                                                          2

12. Not showing up for practice, unless previously excused                                                      2

13. Displays of affection while in uniform                                                                   1-2-3

14. Behavior problems reported by teachers                                                                 1-2-3

16. Minor disregard or disrespect for sponsors or coaches                                           1-2-3

17. Breaking school rules                                                                                             3,6,9

18. Not showing up for a game without notifying coach                                              6

19. Major disregard or disrespect for sponsors or coaches                                            6,9

20. Participation in a Social Network (My Space, Facebook, etc.)               IMMEDIATE  that in any way displays disrespect or a negative attitude for               DISMISSAL

         peers, team, school, coach, teachers or principal. 

         Principal and CoachŐs decision is final.

 

 

 

 

*Opportunities will be given intermittently throughout the year to earn merits back.   Merits will be earned at a rate of one (1) per every half hour worked, with a one-hour minimum required.  

 

 

 

 

 

 

 

 

 

 

 

 

 

Student/Parent Copy

Knox Doss Middle School at Drakes Creek

Cheerleading Demerit System 2009-2010

 

Offenses not listed may also warrant demerits at the discretion of the coach/sponsor. Once a cheerleader has reached three demerits, he/she will be benched for an entire game. Please see the definition of benched in the cheerleader agreement. The cheerleader must still attend the game dressed in uniform. At her discretion, the coach may choose to have the cheerleader do extra conditioning as a result of demerits instead of being benched. Once extra conditioning or benched time has been served, the demerit is NOT gone from the record. After six demerits, cheerleader will receive a probation letter. If a cheerleader reaches nine demerits, the cheerleader will be removed from the squad, whether or not a probation period has occurred.

 

 

Offense                                                                                                            # of demerits 

1. Not properly dressed for practice (shoes, clothes, etc)                                               1

2. Wearing fingernail polish/ jewelry to games/ practices                                               1

3. Chewing gum during games or practice                                                                   1

4. Moving about, unnecessary talking during game                                                      1

5. Being late to practice                                                                                                2

6. Being late to a game                                                                                                 2

7. Acting silly / unnecessary talking while building or cheering                                    2

8. Showing poor sportsmanship toward squads, teams, fans                                          2-3

9. DŐs on report card                                                                                                   1

10. FŐs on report card                                                                                                              2

11. Showing up for a game in incorrect uniform                                                          2

12. Not showing up for practice, unless previously excused                                                      2

13. Displays of affection while in uniform                                                                   1-2-3

14. Behavior problems reported by teachers                                                                 1-2-3

16. Minor disregard or disrespect for sponsors or coaches                                           1-2-3

17. Breaking school rules                                                                                            3,6,9

18. Not showing up for a game without notifying coach                                              6

19. Major disregard or disrespect for sponsors or coaches                                            6,9

20. Participation in a Social Network (My Space, Facebook, etc.)               IMMEDIATE  that in any way displays disrespect or a negative attitude for               DISMISSAL

         peers, team, school, coach, teachers or principal. 

         Principal and CoachŐs decision is final.

    

 

 

*Opportunities will be given intermittently throughout the year to earn merits back.   Merits will be earned at a rate of one (1) per every half hour worked, with a one-hour minimum required. 

 

 

 

I have read the above policy and agree to abide by this demerit system.

 

 

 

_______________________________________________

Cheerleader signature                                         Date

  

 

MUST BE RETURNED BY APRIL 27, 2009

 

Knox Doss Middle School at Drakes Creek Cheerleading

 

Student and Parent Agreement to Cheerleader Regulations and Guidelines

 

StudentŐs Name:   __________________________________________________

 

STUDENT SECTION

á   I have read and understand the Knox Doss Middle School at Drakes Creek Cheerleader Policies Guidelines. _____

á   I understand that all practices, games, and other cheer obligations are mandatory and agree to be present for all of them. _____

á   I agree to attend the mandatory parent meeting on May 3rd (both the cheerleader and parent). ______

á   I agree to abide by these regulations if I am selected as cheerleader. _____

 

________________________________________________

Student Signature                                               Date

 

PARENT/GUARDIAN SECTION

á   I agree to attend the mandatory parent orientation meeting (both the cheerleader and parent) ______

á   I have read and understand the Knox Doss Middle School at Drakes Creek Cheerleader Policies and Guidelines. _____

á   I have discussed the requirements, responsibilities, and rules with my child. ______

á   I understand that there are financial obligations that come with my student being a member of a cheer team. I agree to comply with the financial obligations listed in this Cheerleader Agreement. In the event of a dismissal, all balances are due and payable to the school. ______

á   I understand that my child must attend all practices (unless excused by the coach) and tryout sessions, or my child will not be considered for a cheerleading position _______

á   I understand that qualified judges will evaluate my child, and we agree to abide by the decision of the judges. _______

á   I understand that by the very nature of the activity, cheerleading and gymnastics carry a risk of physical injury. No matter how careful the participant and the coach are, how many spotters are used, or what landing surface is used, the risk cannot be eliminated. The risk of injury includes minor injuries such as muscle pulls, dislocation, and broken bones. The risk also includes catastrophic injuries such as permanent paralysis or even death from landing on the back, neck, or head. _______

á   I understand these risks and will not hold Knox Doss Middle School at Drakes Creek or any of its personnel responsible in the case of accident or injury at any time. ______

á   By signing this, I verify that my child will attend Knox Doss Middle School at Drakes Creek during the 2009-2010 school year. ________

á   Information and/or photos pertaining to my child (circle one)   may    may not   be used in news releases and publications.

á   I agree to support and uphold these cheerleading regulations if my student is selected as cheerleader.

             

_________________________________________________________

Parent / Guardian Signature                                 Date

 

 

MUST BE RETURNED BY APRIL 27, 2009

Knox Doss Middle School at Drakes Creek Cheerleading

Student Information Form 2009-2010

 

Personal Information:

StudentŐs Name ___________________________________ Cell Phone ______________ 

 

StudentŐs Address _____________________________ City _____________ Zip________

 

Age_______ Date of birth ________________ Grade in 2009-10  _____

 

Home Phone______________________

 

MotherŐs Name ________________________ MotherŐs Work Phone_________________

 

MotherŐs Cell Phone _____________ MotherŐs Email_____________________________

 

FatherŐs Name _________________________ FatherŐs Work Phone__________________

 

FatherŐs Cell Phone ______________ FatherŐs Email______________________________

 

 

Medical History:

PhysicianŐs Name ____________________________ Phone _______________________

 

Emergency Contact ________________________ Phone __________________________

 

Please check the following conditions that pertain to you:

 

_____ Allergies                     _____ High Blood Pressure    _____ Convulsions/Epilepsy

 

_____ Psychological disorder          _____ Asthma               _____ Bone/joint weakness

 

_____ Diabetic                                _____ Kidney disease   _____ Heart Trouble

 

_____ Other_________________________                        _____ Contact lenses

 

 

Medical Condition currently being treated______________________________________

 

Medications currently being taken: ___________________________________________

 

 

 

 

Please inform KDMS if any of this information changes.

 

 

 

 

 

 

MUST BE RETURNED BY APRIL 27, 2009

Knox Doss Middle School at Drakes Creek

Cheerleading

 

Insurance Information Form

 

Student/AthleteŐs Name (PRINT) ___________________________________

 

Date of Birth_____________ Allergies_______________________________

 

PLEASE PROVIDE THE INFORMATION REQUESTED BELOW. THIS INFORMATION IS CRITICAL TO PROMPT TREATMENT IN THE CASE OF EMERGENCY AND ACCURATE BILLING PROCEDURES. AN INCOMPLETE FORM WILL DELAY THE PARTICIPATION OF THE ATHLETE AND/OR THE PROCESSING OF THE STUDENTS FORMS.

 

Please include a copy of your childŐs insurance card.

 

Parent/Guardian Name ___________________________________________________

 

Address________________________________________________________________

 

Home Phone ______________________ Work Phone __________________________

 

Cell Phone________________________ 

 

Policy Holder Name ______________________________________________________

 

Relationship to student ________________________

 

Insurance Company Information

 

Name _________________________________________________________________

 

Address________________________________________________________________

 

Group # __________________________ID# __________________________________

 

Effective Date of Policy_____________________Expiration Date __________________

 

Primary Physician _______________________________________________________

 

PhysicianŐs Office Number_______________________________

 

HMO__________   or PPO__________ (Please check one)

 

 

MUST BE RETURNED BY APRIL 27, 2009

Knox Doss Middle School at Drakes Creek Cheerleading

 

MEDICAL AND INJURY RELEASE FORM

 

 

Student-AthleteŐs Name ________________________________ Date _____________

 

Address: _______________________________________________________________

 

Date of Birth________________ 

 

Permission to Treat Statement:

Permission is hereby granted to Knox Doss Middle School at Drakes Creek to proceed with any medical treatment deemed necessary in the event the parent/guardian cannot be contacted. In the event of serious illness, the need for major surgery or significant accident or injury, I understand that an attempt will be made to contact me in an

expeditious manner. In the event I cannot be contacted, permission is granted to render all treatment deemed necessary in the best interest of the above-named athlete.

 

_________________________________         _________________________________

Parent/Guardian Name (print)                            Parent/Guardian Signature

 

__________________________  ____________________   _____________________

Relationship to Student-Athlete               Home Phone                          Work Phone

 

Parent/Guardian Address: _________________________________________________

 

Acceptance of Risk Statement:

 

I, ___________________________, am aware of and accept the risk of injury associated with participating in cheerleading. I will do my part to reduce the risk of injury by acquiring and maintaining my peak physical condition. I will follow the advice of the medical and coaching staff in preparing to participate and in the event of injury or accident incurred due to participating in my sport. If I do not understand or if I have any

questions concerning this Acceptance of Risk Statement, I will get a detailed explanation from my coach prior to my participation.

 

________________________________           _______________________________

Student-AthleteŐs Name (print)                          Student-AthleteŐs Signature

 

________________________________           _________________________________

Parent/Guardian Name if under 18 (print)          Parent/Guardian Signature if under 18

 

Date: __________________

 

MUST BE RETURNED BY APRIL 27, 2009

Knox Doss Middle School at Drakes Creek Cheerleading

Teacher Recommendation Form

 

STUDENT ___________________________ TEACHER _________________________

 

It is the intention of the Knox Doss Middle School at Drakes Creek Cheerleading squad to be some of the best student representatives at KDMS. In order to achieve this goal, we need your input on the behavior and attitude that you have seen displayed both in your classroom and throughout the school building. The above student has asked you to evaluate her as a part of her overall tryout score for cheerleading at Knox Doss Middle School at Drakes Creek. Please consider this as you mark your responses on this form. Please return this form to Coach (Brandi Burns) or Asst. Principal (Jodi Green) by Monday April 27, 2009.

 

                                               Points (circle one)

1. Punctuality                        

                                                        0                 More than 10 tardies this year

                                                        1                 7-9 tardies this year

                                                        2                 5-6 tardies this year

                                                        3                 3-4 tardies this year

                                                        4                 1-2 tardies this year

                                                        5                 0 tardies this year

 

2. Respect for Authority 

                                                        0                 Shows no respect for authority

                                                        1                          Disrespectful very often

                                                        2                          Generally disrespectful

                                                        3                          Somewhat disrespectful

                                                        4                          Very Rarely disrespectful

                                                        5                          Never disrespectful

 

3. Respect for Peers 

                                                        0                 Shows no respect for peers                                                                                                          1                             Disrespectful very often to peers

                                                        2                          Generally disrespectful to peers

                                                        3                          Somewhat disrespectful to peers

                                                        4                          Very Rarely disrespectful to peers

                                                        5                          Never disrespectful to peers

 

4. Effort/Quality of Work

                                                        0                 Never displays any effort

                                                        1                          Shows very little effort/very poor work quality      

                                                        2                          Shows little effort/poor work quality

                                                        3                          Shows effort/average work quality

                                                        4                          Shows good effort/good work quality

                                                        5                          Shows excellent effort/excellent work quality

 

5. Honesty and Integrity 

                                                        0                 Always dishonest/lacking in integrity

                                                        1                          Often is dishonest and lacking in integrity

                                                        2                          Sometimes dishonest and lacking in integrity        

                                                        3                          Generally honest and displays some integrity

                                                        4                          Almost always honest and shows good integrity

                                                        5                          Always honest and shows excellent integrity

 

Other comments related to rankings above:

 

Knox Doss Middle School at Drakes Creek Cheerleading

Teacher Recommendation Form

 

STUDENT ___________________________ TEACHER _________________________

 

It is the intention of the Knox Doss Middle School at Drakes Creek Cheerleading squad to be some of the best student representatives at KDMS. In order to achieve this goal, we need your input on the behavior and attitude that you have seen displayed both in your classroom and throughout the school building. The above student has asked you to evaluate her as a part of her overall tryout score for cheerleading at Knox Doss Middle School at Drakes Creek. Please consider this as you mark your responses on this form. Please return this form to Coach (Brandi Burns) or Asst. Principal (Jodi Green) by Monday April 27, 2009.

 

                                               Points (circle one)

1. Punctuality                        

                                                        0                 More than 10 tardies this year

                                                        1                 7-9 tardies this year

                                                        2                 5-6 tardies this year

                                                        3                 3-4 tardies this year

                                                        4                 1-2 tardies this year

                                                        5                 0 tardies this year

 

2. Respect for Authority 

                                                        0                 Shows no respect for authority

                                                        1                          Disrespectful very often

                                                        2                          Generally disrespectful

                                                        3                          Somewhat disrespectful

                                                        4                          Very Rarely disrespectful

                                                        5                          Never disrespectful

 

3. Respect for Peers 

                                                        0                 Shows no respect for peers                                                                                                          1                             Disrespectful very often to peers

                                                        2                          Generally disrespectful to peers

                                                        3                          Somewhat disrespectful to peers

                                                        4                          Very Rarely disrespectful to peers

                                                        5                          Never disrespectful to peers

 

4. Effort/Quality of Work

                                                        0                 Never displays any effort

                                                        1                          Shows very little effort/very poor work quality      

                                                        2                          Shows little effort/poor work quality

                                                        3                          Shows effort/average work quality

                                                        4                          Shows good effort/good work quality

                                                        5                          Shows excellent effort/excellent work quality

 

5. Honesty and Integrity 

                                                        0                 Always dishonest/lacking in integrity

                                                        1                          Often is dishonest and lacking in integrity

                                                        2                          Sometimes dishonest and lacking in integrity        

                                                        3                          Generally honest and displays some integrity

                                                        4                          Almost always honest and shows good integrity

                                                        5                          Always honest and shows excellent integrity

 

Other comments related to rankings above:

 

Knox Doss Middle School at Drakes Creek Cheerleading

Teacher Recommendation Form

 

STUDENT ___________________________ TEACHER _________________________

 

It is the intention of the Knox Doss Middle School at Drakes Creek Cheerleading squad to be some of the best student representatives at KDMS. In order to achieve this goal, we need your input on the behavior and attitude that you have seen displayed both in your classroom and throughout the school building. The above student has asked you to evaluate her as a part of her overall tryout score for cheerleading at Knox Doss Middle School at Drakes Creek. Please consider this as you mark your responses on this form. Please return this form to Coach (Brandi Burns) or Asst. Principal (Jodi Green) by Monday April 27, 2009.

 

                                               Points (circle one)

1. Punctuality                        

                                                        0                 More than 10 tardies this year

                                                        1                 7-9 tardies this year

                                                        2                 5-6 tardies this year

                                                        3                 3-4 tardies this year

                                                        4                 1-2 tardies this year

                                                        5                 0 tardies this year

 

2. Respect for Authority 

                                                        0                 Shows no respect for authority

                                                        1                          Disrespectful very often

                                                        2                          Generally disrespectful

                                                        3                          Somewhat disrespectful

                                                        4                          Very Rarely disrespectful

                                                        5                          Never disrespectful

 

3. Respect for Peers 

                                                        0                 Shows no respect for peers                                                                                                          1                             Disrespectful very often to peers

                                                        2                          Generally disrespectful to peers

                                                        3                          Somewhat disrespectful to peers

                                                        4                          Very Rarely disrespectful to peers

                                                        5                          Never disrespectful to peers

 

4. Effort/Quality of Work

                                                        0                 Never displays any effort

                                                        1                          Shows very little effort/very poor work quality      

                                                        2                          Shows little effort/poor work quality

                                                        3                          Shows effort/average work quality

                                                        4                          Shows good effort/good work quality

                                                        5                          Shows excellent effort/excellent work quality

 

5. Honesty and Integrity 

                                                        0                 Always dishonest/lacking in integrity

                                                        1                          Often is dishonest and lacking in integrity

                                                        2                          Sometimes dishonest and lacking in integrity        

                                                        3                          Generally honest and displays some integrity

                                                        4                          Almost always honest and shows good integrity

                                                        5                          Always honest and shows excellent integrity

 

Other comments related to rankings above: