MarianHigh School

Summer Physical Education 2015

Calendar:Monday June 8th- Friday June 26th

Classes meet Monday – Friday 9-11:30am with flexibility on Field Trip days

Overview:Students will be required to participate fully in all sports activities offered. Students may be involved in off-site field trips, therefore an emergency medical release form and a permission to transport forms (which are included) must be returned before registration is complete.

Enrollment and fee:A limited number of students will be permitted to enroll for summer physical education at MarianHigh School. Enrollment will be on a first come, first serve basis. All registration paperwork and the entire $300 fee must be received by Mrs. Dyer by April 13th, 2015in order to be eligible for this class. No registration will be processed without the entire fee, signature form, and emergency medical form. Please make checks payable to Marian High School.

Credit:Upon successful completion of the summer physical education class, a full semester of credit is earned.

Because the course is accelerated, points will be deducted if a student is absent one day; resulting in a grade no higher than a B. No credit will be issued if a student is absent more than one day. There will be no fee refund if a student has been withdrawn because of absenteeism. If a student would miss morethan one day for extenuating circumstances (elementary school release date), please inform the instructor immediately. Do not sign up for the course if a prior family trip and/or an appointment are scheduled.

Tardy:Students must arrive at the school on time. Some of the activities are off campus and we will be using a bus for transportation. We cannot wait for students to arrive. If a student arrives at the school and the bus has already left, then it will be the responsibility of the student to get to the facility to meet the class. Excessive tardiness will also result in a lowering of the student’s grade.

Regulations:If a student has some injury/condition that limits his/her physical activity, the school andinstructor must be notified in writing before the start of summer class.

Dress code:Students must wear appropriate summer clothing (i.e.: no flip flops, no half shirts, no short shorts, no dangling earrings, etc.) Any student not abiding by the dress code will be asked to change or leave the class immediately.

Summer physical education is a service that MarianHigh School is providing for its students, students are expected to cooperate fully. Any student who is uncooperative or is a behavior problem will be removed from the class and no credit or fee refund will be given.

Please return the registration and medical forms, as well as the course fee to Marian c/o Mrs. Dyer.

Registration Form; Summer Physical Education – 2015

Student Name______Date of Birth ______Male _____Female_____

I have read and understand the regulations and expectations for summer physical education:

Student signature______

Parent signature______

Emergency Medical Authorization Form

Purpose: To enable parents and guardians to authorize the provision of emergency treatment for children who become ill or injured while under school authority, when parents/guardians cannot be reached.

First Parent contact: ______Daytime phone: ______

Second Parent contact______Daytime phone: ______

Third contact______Daytime phone: ______

Relationship______

To grant consent

I hereby give consent to the following medical care providers and local hospital to be called:

Family Physician______Phone: ______

Dentist______Phone: ______

Medical specialist______Phone: ______

Local hospital______Phone: ______

In the event reasonable attempts to contact me have been unsuccessful, I hereby give my consent for (1) the administration of any treatment deemed necessary by above-named doctors, or, in the event the designated preferred practitioner is not available, by another licensed physician or dentist; and (2) the transfer of the child to any hospital reasonably accessible. This authorization does not cover major surgery unless the medical opinions of two other licensed physicians or dentists, concurring in the necessity for each surgery, are obtained prior to the performance of such surgery.

Medical conditions of child to be aware of: ______

______

Allergies: ______

Asthma: Yes______No ______Carries an inhaler: Yes______No______

Medication taken: ______

Signature______Date: ______

Refusal to consent: I do not give my consent for emergency medical treatment of my child. In the event of illness or injury requiring emergency treatment, I wish the school to take the following action______

Signature______Date: ______