LAKE NELSON ADVENTIST ACADEMY
Empowering Students Through Christian Education
555 South Randolphville Road -Piscataway, NJ 08854-5092
(732)981-0626 Fax (732) 981-0770
Lake Nelson Athletics Program
LNaa LIONS
LAKE NELSON ADVENTIST ACADEMY
Empowering Students Through Christian Education
Dear Parents/Guardians and Students:
Thank you for your interest in athletic sports at Lake Nelson Academy. In everything that we do, Lake Nelson strives for excellence. We are deeply aware that all of our help comes from God. We begin this athletics program by placing it in God’s hands. Our Lake Nelson motto is,Empowering students through Christian Education and on our seal that education is comprised of the physical, mental and spiritual. The LNAA athletics program takes the physical education one step forward as we embark on opening the athletics department. We thank you for taking an interest and for your continued support.
- Students participating in sports are expected to maintain a level of scholastic achievement that will enable them to graduate and succeed in the future. Please review handbook for complete rules and regulations.
- No student will be cleared to participate in practice for a sport unless ALL documentation is completed, signed as indicated, cleared, and on file.
- Incomplete forms will be returned and the student will NOT be cleared for play until all forms are complete.
We look forward to your child’s participation in the Athletics program. Thoroughly checking the packet before submitting it will enable your child to participate in practices without delay. Should you have any question or concerns, please contact the Athletic Director, Anna-Gayle Hemmings or a sports coordinator.
Thank you,
Athletics Committee
LNS LiONS Athletics Teams:
**Spots on teams are limited and will go to the first registrars: Boys and Girls are welcome on all teams**
You must be in 6th grade and up to register to participate on all teams except gymnastics which will be for Kindergarten and up.
Fall Registration Open: *September 05, 2017*
Fall Registration Closed:
Fall– 9 Weeks (September, October, November)
Soccer (Maximum – 26 Players)*
**September 12, 2017 – November 17, 2017**
Practice – 2 days/Week
Winter Registration Open:*November 13, 2017*
WinterRegistration Closed:
Winter – 9 Weeks (January, February, March)
Basketball (Maximum – 14 Players)*
Gymnastics/Cheerleading Squad (Krd Grade and up)(Maximum – 26 )*
**January 08, 2018 – March 08, 2018**
Practice – 2 days/Week
Spring Registration Open:*February12, 2018*
Spring Registration Closed:
Spring – 9 Weeks (March, April, May)
Soccer (Maximum – 26 Players)*
Volleyball (Maximum – 16 Players)*
March 12, 2018 – May 23, 2018
No Practice – Week of April 23rd in preparation for Science Fair
Practice – 2 days/Week
Checklist for Students and Parents who are completing the Lake Nelson Athletics Packet
Before submitting the packet of forms for your child, please check to see that all of the information that is required is complete. No student may participate until his/her packet has been approved.
_____ Athlete Registration Form
_____ Student Responsibility in Rules of Conduct
_____ Parent Responsibility in Rules of Conduct
_____ 2017-2018 Accident Waiver and Release of Liability
_____ Health History Forms
_____ Supplemental History Form
_____ Physical Examination Form
_____ Clearance Form
_____ Parent and Student read and sign the Concussion information sign-off form
_____ Parent and Student read and sign the Sudden Cardiac Death information sign-off form
_____ If your child has asthma or use an EpiPen, complete the Asthma Treatment Plan
(Asthma Treatment Forms)
_____ All signatures and dates are completed on all forms. ALL FORMS MUST BE COMPLETE.
_____ The forms are submitted after registration opens and no later than Registration due date
Sincerely,
Athletics Department
Lake Nelson Athletics Registration form
Student Name:______Grade:______
Sport:______Season: Fall Winter Spring Gender: M F
Street Address/ Apt. #:______
City/State:______Zip Code:______
Phone Number (H) :______Phone Number (W) :______Phone Number (C) :______
In Case pf emergency, contact information:
Name:______Relationship:______
Street Address/ Apt. #:______
City/State:______Zip Code:______
Phone Number (H) :______Phone Number (W) :______Phone Number (C) :______
Alternate Emergency Contact:
Name:______Relationship:______
Street Address/ Apt. #:______
City/State:______Zip Code:______
Phone Number (H) :______Phone Number (W) :______Phone Number (C) :______
Pre-existing Medical Conditions:______
______
Medications Used:______
Allergies:______
Any illness or injury requiring medical attention since the beginning of last sports season? Yes No
If yes, Please specify with dates:______
______
Has the student ever been diagnosed with a concussion? Yes No
If yes, Please specify with dates:______
______
Does student Cary: Asthma Inhaler: Yes No Does student Cary: EpiPen: Yes No
I grant permission for the Athletic Coaches at Lake Nelson to administer emergency aid and treat minor injuries that may occur to my child as a result of participating in athletics.
I further give permission for the treatment of my son/daughter by emergency medical teams.
Parent / Guardian Signature:______Date:______
Athlete Signature:______Date:______
Fees & Uniform
Registration Fee per Student: $100.00
Sports Uniform Fee: To be specified by coaches
Circle size for uniform: For fittings please see Mrs. Hemmings
YOUTH - YXS YS YM YL YXL
ADULT - AXS AS AM AL AXL A2XL A3XL A4XL
Rules of Conduct
These Rules of Conduct are set in place to ensure the safety and well-being of anyone in association with Sports at Lake Nelson including, the players, coaches, judges, parents and spectators. Good sportsmanship will follow the rules of conduct and embrace them for practices, games and in everyday activity. Students and parents are held accountable to these rules.
Athlete Responsibility
-Students are expected to be on time for practices and games
-Students will play by the rules governed by the game
-Students will not involve themselves in any verbal or physical confrontations
-Students will abide by school rules and policies as specified in the Lake NelsonAcademy Handbook
-Students will show proper respect to coaches, judges, teammates, officials, spectators, and others
-Students will wear appropriate clothing during practices as specified by the sports that they play
-Students will maintain proper care of sports uniform and will wear clean and neat uniforms at each game
-Students will carry themselves with dignity at all times and as such will refrain from inappropriate language, behavior and attitude
-The use of any form of drugs is not permitted unless declared necessary by a medical Doctor and declared on athletics medical forms by which the coaches are made aware
- Illegal substance abuse and alcohol use is not permitted
-Grades must be maintained of a GPA level of 3.0 and above
-Students will abide by the rules of the game and respect all judgments and calls made by coaches and referees
-Students will be gracious with other team members and opposing team members whether they are losing or winning
-Students will maintain a Christ-like attitude in all situations and therefore conduct themselves with good sportsmanship
Athlete Signature:______Date:______
Parent Responsibility
-Parents will abide by the rules of the game and respect all judgments and calls made by coaches and referees
- Parents will not involve themselves in any verbal or physical confrontations
- Parents will show proper respect to coaches, judges, team members, officials, spectators, and others
- Parents will carry themselves with dignity at all times and as such will refrain from inappropriate language, behavior and attitude
- Parents will be gracious with other team members and opposing team members whether they are losing or winning
- Parents will maintain a Christ-like attitude in all situations and therefore conduct themselves with good sportsmanship
Parent Signature:______Date:______
Parent/Guardian Support
We would greatly appreciate your help and support in our Athletics Program. Please circle below with what kind of help you are able to give:
Game day transportation Monetary Donations Help at practices Snack sales at games
2017-2018 Accident Waiver and Release of Liability
This Accident Waiver and Release of Liability (the “Release”) is executed by______(the “Participant’s Guardian”) for the participant whose name is ______(the “Participant”) and whose address is:______In consideration for the Participant being permitted to participate in Lake Nelson SDA School sports 2017-2018, the undersigned does hereby release, waive and forever discharge Lake Nelson SDA School, its controlling persons, successor, affiliates, assigns, shareholders, members, managers, directors, officers, employees, agents or representatives (collectively, the “Company”) from and against any and all liability for any harm, injury damage, claims, demand, actions, causes of action or costs and expenses of any nature from which Participant may have or which may hereafter accrue to the Participant, arising out of or related to any loss damage or injury, including but not limited to suffering, pain, disability and severe injury (including death), that may be sustained by Participant in conjunction with Participant’s involvement in the Activity.
Participant has signed the Release in full recognition and appreciation of the dangers, Hazards and risks involved with the Activity. Participant further attests and Participant’s Parent/Guardian agrees that the Participant has individually assumed the risks Involved with this Activity.
Participant understands and acknowledges that this Release is binding on Participant and Participant’s family, estate, heirs, administrators, representatives and assigns. Participant further agrees to hold harmless, indemnify and defend the Company from any claim by Participant or Participant’s family arising out of Participant’s involvement in the Activity.
Participant and Participant’s Parent/Guardian agree that the Company is granted permission to seek and obtain emergency medical treatment, if necessary, and that such action by the Company does not constitute any assumption of responsibility by the Company for any injury or damage, which might arise out of or in connection with such authorized emergency medical treatment.
Participant certifies that she/he is physically fit and in good health and has not been advised otherwise by any qualified medical personnel. Participant is not aware of any health-related reasons or problems, which would preclude or restrict Participant’s ability to take part in the Activity.
If any term or provision of the Release shall be held illegal, or unenforceable, or in conflict with any law governing this Release, the validity of the remaining portions shall not be affected.
Parent Phone (Home): ______(Cell): ______
Additional Emergency Contact Name and Phone: ______
Signature of Participant’s parent or Guardian: ______
Health Packet
The New Jersey SDA Conference of Education and the Lake Nelson SDA School require that all students competing in interscholastic athletic programs have a medical examination before an athlete can be considered for an athletic squad or team.
The NJ Health Department has issued an Athletic Pre-Participation Physical Evaluation Form with 4 parts:
- History Form
- Supplemental History Form
- Physical Examination Form
- Clearance Form
These are the only forms that can be used. Physical exams must take place within 365 days of the start of practice for the sport in which participation is declared.
- Athletic physicals must be conducted by the student’s own physician/healthcare provider and the approved forms must be returned to the school. During the school year, the completed forms can be returned to the nurse.
- Any student who uses an EpiPen or has and Inhaler for Asthma or allergy related symptoms MUST have the Asthma Treatment Plan form completed.
*Note: Any student who uses an EpiPen or has an Inhaler for Asthma should pick up an Asthma Treatment Plan form.
Sincerely,
Athletics Committee
Please print these health forms, read and sign.
Health Forms:
Concussion Forms:
Sudden cardiac death information:
Sudden cardiac death sign off form:
Asthma treatment plan:
Important Notice
*If you have Asthma or use an EpiPen you must have a yearly clearance form filled out by a physician before participation in any sport.
*If you had asthma in the past and no longer need an inhaler, a note from a physician stating that asthma is not present is needed before participation in any sport.
*Any and all Cardiac conditions including Innocent Heart Murmurs must get clearance from a Cardiologist before participation in any sport.
Cancelled Practice or Game
In the event that a game or practice has to be cancelled, we will send out notifications by email schoolwide to all parents and guardians. Every effort will be made to send notices out early so that you can make the appropriate arrangements to pick up your child. In the event that accommodations cannot be made and your child has to stay in after care, their aftercare fee will be waived as they are in the athletics program for that season. Please be patient with us if notices are not able to be sent out from early. Our coaches are volunteers and they do their best to make all practices. We thank them for the time they have volunteered in helping us run our athletics program at Lake Nelson.
Thank you,
Mrs. Hemmings
Athletics Chairman