INTERSCHOOL ATHLETIC PARTICIPATION INFORMATION and CONSENT FORM

Description of Interschool Athletics

The student will be participating in the following activity: Tackle Football The season dates are currently scheduled from: August 17 to November 7, 2026. The practices days & times are typically: Monday - Wednesday (some Thurs & Fri) - 3:30-6:00pm The game days are typically: Thursdays (occasional Friday) The game times vary between: 5:00pm & 7:30pm

Breakdown of Cost to Student

League Fees $135.00 Transportation $50.00 Photography, Athletic Therapy Services & Supplies $40.00 Extras: Socks, Mouthguard, Knee Pads & Belt $50.00 Equipment Use: Uniforms, balls, pads, helmets, etc… $100.00 Total Cost: $375.00 Optional Cost If you do not already own a Girdle you will need to purchase one $45.00 Team Clothing Order (Sweats, hoodie, ¼ zip, long sleeve) $125.00 Athletic Fee (paid once per school year) Athletic Banquet Ticket $50.00 and Osborne Athletics Swag (Check which optional cost you want to add below)

Fees (INCLUDING EQUIPMENT DEPOSIT) will be added to the student account on SchoolZone. Please pay directly on SchoolZone. If you do not have access to do this the office will accept Credit or Debit. Cheques will not be accepted. At the conclusion of the season any money remaining in the team account will be transferred to a school account for the replacement purchasing of equipment, uniforms, etc…

Detailed description of contingency plan: In the event that the original itinerary is altered for any reason, parents/guardians, school administration and Division Support Services will be notified by phone. Detailed description of any unusual or significant hazards: Football has hazards which include but are not limited to: ankle sprains, strains, torn ligaments, jammed fingers, broken bones, broken wrists, head and neck injuries, concussion, hand/ankle/knee injuries, loss of teeth, cuts and abrasions - all in relation to falls, body collisions, and collision with equipment. Participants may also experience dehydration and fatigue. Description of the Supervision Number of Participants–students & supervisors: 50 : 8-10 Name of teacher-leader in charge: Jon Waters & Kate Greabeiel Name(s) of coach(es): Kyle Sommerville, Ernesto Perla, Jim Nahrebeski, Tom Dennehy, Spencer Fraser, Alex Bischof, Ahmed Ghanem, William Clark & Jack Keddie Detailed description of all activities: Detailed schedules can be found on the Metro website: https://metroathletics.ca Practice & Game schedules are available through Google Classroom/Calendar, TeamLinkt & https://www.sportstax.ca/lillianosborne/football Coaches will seek advice and assistance from experts to ensure that the Safety Guidelines for Secondary Interschool Athletics in Alberta are in place. https://injurypreventioncentre.ca/downloads/policies/SG_IA_Final_2012.pdf To ensure complete safety of our students, the following requirements for volunteers are in effect: All volunteers must submit a Division Volunteer Registration form An application for a police records check must be submitted by volunteer coaches, volunteer chaperones of overnight field trips and volunteer drivers transporting students. Supervisory arrangements (on bus, at ski hill, etc.): A minimum of one coach (but generally 4-5) will be present at all practices and games. Safety precautions (e.g., wearing helmet on skating rink, supervisors with first aid training, for alpine skiing/snowboarding: mandatory lessons or CSIA certification): Jon Waters (Emergency First Aid & Level C CPR (exp 2028) & Kate Greabeiel (Standard First Aid & Level C CPR (exp 2027) have first aid training and will be on-site during practices and games.. Other coaches are also certified in First Aid at various levels. An athletic first aid kit will be available at all games and practices. Whenever possible a certified Athletic Therapist will be present for games. Student-Athletes will all be fitted with proper equipment and will be expected to wear it at all times during practices and games as instructed by coaching staff. Coaching staff will provide instruction on proper techniques for tackling, etc… Emergency procedures to be followed in the event of injury, illness, or unusual circumstances: In the event of an injury or illness, a typical emergency response to be followed by supervisory staff may include the following: assessment of the situation and provision of first aid as necessary decision to involve emergency response teams (paramedics, etc.) contact with parent/guardian/emergency contact (when possible) decision to proceed with emergency assistance and necessary medical treatment Unusual circumstances may include plans to respond to any students whose unacceptable behavior interferes with the safe, respectful or orderly operation of the field trip. Parents, school administration, and Division Support Services will be notified of any emergencies by phone. Other Considerations: We ask you to consider the following and ask the teacher lead if you have concerns related to: - Any unusual factors such as rigorous physical activity, water related activities or water sports; - Any special risks associated with the activity; - A reminder that parents or guardians must inform the Teacher in charge about any relevant medical conditions of the student; - Other relevant information about the trip/activity which may influence the parents' or guardians’ decision to withhold permission. Thank you for considering your child’s participation in these activities. Principal: Mr. Mike Morison Teacher(s): Jon Waters & Kate Greabeiel

Consent and Authorization Important: Parent(s)/Guardian(s). The following sections contain important information. Please read them carefully and ensure that you understand them completely.

Notice of Risk Some forms of athletic competition involve rigorous physical contact among students, the use of equipment which may result in accidents, strenuous physical exertion, and other exposures to risk injury. Students will be instructed in the proper techniques to be used in practice and competition and the proper use of equipment and facilities. However, you are advised that instruction, precaution and proper equipment may not prevent some accidents resulting in serious, traumatic injury. Changes to Itinerary and Associated Costs I understand that the athletic participation will follow the description of the activities set out above as closely as possible. I also understand that contingencies can arise that necessitate sudden changes to activities and destinations. I agree that the supervisors of athletic participation have full authority to make decisions related to team schedules and travel without obtaining my further consent. If such changes involve extra cost, I agree to repay the school Division for those costs associated with my child. Cancellation of Field Trip I understand that the Superintendent of Schools has full authority to cancel or modify any athletic activity without notice for any reason the Superintendent deems appropriate. I also understand that such cancellation may mean that some or all of the money I have paid for the field trip might not be refundable. I agree that the Superintendent of Schools has such authority and that the school district will not reimburse me for any money I may have lost as a result of such cancellation. Discipline I understand that my child must obey the rules established by the school and the field trip supervisors. I agree that if my child severely breaches the rules he or she might be sent home. I agree that if my child is sent home under such circumstances, I will be responsible for all associated costs incurred, including the cost of special travel arrangements. Illness and Injury I understand that illness and injuries sometimes occur on field trips. I agree that if illness or injury necessitates the expenditure of money for special travel arrangements or any other reason deemed necessary by the field trip supervisors, I will be responsible for all of those costs. I authorize any of the adult supervisors on the field trip to consent to any medical attention my child may require. Student Accident Insurance Edmonton Public Schools purchases Blanket Student Accident Insurance for the benefit of students and parents. However, that insurance is not applicable to international field trips. Parents are strongly encouraged to review coverage under the Blanket Student Accident policy. Families may purchase additional insurance called “Voluntary Student Accident Insurance by StudyInsured”. Parents are encouraged to review this additional insurance coverage. I agree that I will purchase Voluntary Student Accident for my child if I wish to have such insurance. Protection of Privacy – Personal information provided is collected in accordance with section 4(c) of the Protection of Privacy Act (POPA) and protected in accordance with section 10 and used and disclosed in accordance with sections 12 and 13 of the Act. The information you provide will be automatically collected by Edmonton Public Schools’ Risk Management & Insurance Department and may be shared with the Division’s insurance broker, insurance adjuster, legal counsel, or any other parties involved in a legal proceeding related to the incident. This information will be used to monitor incident trends and to investigate and manage incidents that occur within Edmonton Public Schools, including any related insurance or legal matters. Information collected may be transmitted to and stored on servers outside of Edmonton Public Schools, Alberta and Canada and Edmonton Public Schools cannot guarantee protection against disclosures as a consequence of foreign laws. Edmonton Public Schools may use automated systems in processing this collection of personal information. Should you require further information about collection, use and disclosure of this collection of personal information, please contact: insurance@epsb.ca or 780-429-8192. For general information about the Protection of Privacy Act regarding collection, use and disclosure, please contact: accessandprivacy@epsb.ca or 780-429-8350.

Teachers will carry students’ medical information and will keep students' prescription medication secure. Students who may experience a medical emergency due to anaphylaxis, diabetes, epilepsy or other serious or life-threatening conditions shall, when developmentally appropriate, carry these medications securely on their person, with the written consent of parents. The required form, "Authorization for the Administration of Prescription Medication", should be part of the student's Medical Management Plan at the school. Teachers remain responsible for monitoring and recording the process of self-administration of medication.