Safety Guidelines for Secondary Interschool Athletics in Alberta

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Continued from previous page Have you been convicted of an offense under the Traffic Safety Act or for any motor vehicle-related offence under the Criminal Code during the last three years? Yes No If yes, please provide details:____________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ I hereby declare that I have read and understand the information contained on this form. _____________________________ __________________________ _______________ Volunteer Driver’s Signature Vehicle Owner’s Signature Date Authorization to Release Driver’s Abstract Driver’s Name (in full) ________________________________________________________________ Date of Birth _________________________________ Driver’s Address _________________________________________ City __________________ Postal Code ____________ Home Phone _____________ Business Phone _________________ Driver’s License # ________________________ Activity _________ Expiry Date ___________ Volunteer Staff _______ Volunteer Parent _______ Vehicle Seating Capacity (not counting the driver):_______ Type of Vehicle used ______________ Make _______________________ Model ____________ Name of company you are insured with ________________________________________________________ Company Policy # __________________________________ Expiry Date __________________ I, the undersigned, authorize release of my Driver’s Abstract to the School Board and/or its Insurance Agents. _______________________________________________________ ______________ Volunteer Driver’s Signature Date FOR OFFICE USE ONLY I accept the above named individual as an authorized volunteer driver for the _________ school year for the purpose of ___________________________________________________________________. Signature of Principal/Designate: ____________________________ Date: ___________________ 78 Safety Guidelines for Secondary Interschool Athletics in Alberta - February 2012
Appendix G - Sample Non-Teacher Volunteer Coaching Application Form The following form is to be used when interviewing a potential coach in any one of the following situations: a) The applicant is not an administrator or someone with teaching certification. b) The person’s philosophy and/or expertise is unknown. c) The position to be filled is one of head coach or the person would be asked to teacher/coach by himself/herself. d) The person would be coaching a higher risk sport. e) The principal or designate decide to formally interview for other reasons. Please record pertinent information on this form and keep on file. Interviewers are encouraged to include additional questions deemed relevant to their school. Candidate Name: _________________________________________ Address:_______________________________________ Phone: (Home) ______________ (Work) _____________ E-mail or fax: ___________________________________ Alberta Health Care #: ____________________________ (required upon confirmation of coaching appointment) School Principal/Designate: ___________________ Team in Question:_____________________ Higher Risk Sport: Yes No 1. Please describe your previous coaching experience in __________________________________ (specific sport) as well as coaching experience in any other sport. Include number of years you have taught/coached, age range of players, competitive nature of league and any other details you think are pertinent. ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 2. Describe current certification and/or qualification you hold which would be relevant to coaching ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 3. Describe other coaching professional development sessions you have attended which have helped you learn more about coaching the interschool athletic activity of ___________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 4. Do you have Emergency/Standard First Aid certification and CPR or equivalent? Yes No If yes, what type of First Aid and/or CPR certification is it?_______________________________ Who is the certifying body (e.g., Red Cross)?__________________________________________ What is the expiry date on the certificate?_____________________________________________ Continued on next page Safety Guidelines for Secondary Interschool Athletics in Alberta - February 2012 79
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Safety Guidelines for Secondary Int
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ii Safety Guidelines for Secondary
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TABLE OF CONTENTS Curling .........
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Types of Policies Recommended for S
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Continued from previous page Avoidi
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HOW TO USE THIS DOCUMENT How to Use
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Continued from previous page Offici
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Continued from previous page 2. On-
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Continued from previous page Partic
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Continued from previous page • Ap
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Continued from previous page Cultur
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LOWER MAGNITUDE OF RISK SPORTS Lowe
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Continued from previous page Specia
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Continued from previous page Playin
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26 Safety Guidelines for Secondary
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Continued from previous page o No d
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Continued from previous page Commun
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Page 54 and 55: BASEBALL - FASTBALL All Interschool
Page 56 and 57: CHEER (ACROBATIC) Cheer (Acrobatic)
Page 58 and 59: CHEER (Pom) All Physical Activities
Page 60 and 61: CROSS COUNTRY RUNNING All Physical
Page 62 and 63: DIVING All Physical Activities pg.
Page 64 and 65: FOOTBALL (FLAG, TOUCH) All Physical
Page 66 and 67: GOLF All Physical Activities pg. 1l
Page 68 and 69: RUGBY (FLAG) All Physical Activitie
Page 70 and 71: SOFTBALL (SLOW-PITCH) All Physical
Page 72 and 73: TEAM HANDBALL All Physical Activiti
Page 74 and 75: TRACK AND FIELD - HIGH JUMP All Phy
Page 76 and 77: TRACK AND FIELD - POLE VAULT Track
Page 78 and 79: TRACK AND FIELD • TRIPLE JUMP •
Page 80 and 81: TRIATHLON • SWIM • BIKE • RUN
Page 82 and 83: VOLLEYBALL (INDOOR AND OUTDOOR) All
Page 84 and 85: WRESTLING All Physical Activities p
Page 86 and 87: Safety Guidelines for Secondary Int
Page 88 and 89: APPENDIX A - Sample Secondary Inter
Page 90 and 91: APPENDIX B - Sample Secondary Inter
Page 92 and 93: Continued from previous page ACKNOW
Page 94 and 95: 3. Facility Area: Gymnasium Hallway
Page 96 and 97: APPENDIX E - SAMPLE Form for Off-si
Page 100 and 101: Continued from previous page 5. Wha
Page 102 and 103: 82 APPENDIX I - Sample Safety Check
Page 104 and 105: APPENDIX J SAMPLE SAFETY CHECKLIST
Page 106 and 107: APPENDIX K - SAMPLE SAFETY CHECKLIS
Page 108 and 109: APPENDIX L - Sample Emergency Actio
Page 110 and 111: Appendix M - Sample Medical History
Page 112 and 113: APPENDIX O - ATHLETIC FIRST AID KIT
Page 114 and 115: APPENDIX Q - Policy for the Alberta
Page 116 and 117: Continued from previous page 5. Any
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Page 120 and 121: Continued from previous page implem
Page 122 and 123: APPENDIX S - Suggested Criteria For
Page 124 and 125: Continued from previous page 4. A t
Page 126 and 127: Association Web Link Phone Squash A
Page 128 and 129: APPENDIX W - WATER SAFETY The follo
Page 130 and 131: isk level school authority supervis
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