All students, girls and boys, in grades 3-5, are eligible to join the William Brooks Cross Country Team. Second graders that are 8 years old and any siblings that are 7 years old may be allowed on the team by special request.
The Season will begin with practice on Monday, August 16, and it will end Wednesday, October 6, with the County Finals at the El Dorado Fairgrounds in Placerville (the top 7 runners in each age group qualify for the Finals). There will be a parent meeting at 4:20, AFTER THE FIRST PRACTICE, on August 16 for just a few minutes to introduce the coaches and to answer questions. Students are encouraged to attend at least two practice sessions each week until meets start, then at least one practice each week in addition to the meet. Practices will be on Mondays, Wednesdays and Fridays from 3:15 - 4:15 (2:15 -3:15 on early release days). Please note that on “Spare the Air” days, practice will be held in the Gym. Practices will not be canceled on those days. Meets are as listed below, walk-throughs at 3:00, with races starting at 3:30. There will be bus transportation to the meets. Students must be checked out and picked up at each MEET SITE after the meet. Students should be picked up promptly after practices (and meets), as there will be no supervision after 4:20 (3:20 on early release days).
Forms can be obtained in the office or online at www.buckeyeusd.org/brooks/brooks.html.
Students must turn in their completed permission form before they can begin practice.
NO CHILD WILL BE ALLOWED TO PARTICIPATE WITHOUT SUBMITTING THIS FORM.
Comfortable clothes and running shoes should be worn for practice and the meets
(no cut‑offs or swim wear).
Meets: *
WEDNESDAY 9/08 El Dorado Hills CSD
WEDNESDAY 9/15 Silva Valley Elementary, El Dorado Hills
WEDNESDAY 9/22 LAKE FOREST elementAry, El Dorado Hills
WEDNESDAY 9/29 HOLY TRINITY elementAry, El Dorado Hills
WEDNESDAY 10/06 EL DORADO COUNTY FAIRGROUNDS, PLACERVILLE
(for those that qualify)
* Flyers will be sent home before each meet with directions and special instructions for that meet.
Students who are not behaving at practice or meets will be asked to leave the team; if this happens during the first two weeks, their money will be refunded.
Click here for PDF file Permission slip
WILLIAM BROOKS
CROSS COUNTRY PERMISSION AND EMERGENCY AUTHORIZATION
On 9/8, 9/15, 9/22, 9/29 and 10/6, my child has my permission to visit, respectively, EL DORADO HILLS CSD, SILVA VALLEY ELEMENTARY SCHOOL in EL DORADO HILLS, LAKE FOREST ELEMENTARY SCHOOL in EL DORADO HILLS, HOLY TRINITY ELEMENTARY SCHOOL in EL DORADO HILLS, and the EL DORADO COUNTY FAIRGROUNDS in PLACERVILLE (for those that qualify), and to participate in the cross country competitions held at each of these facilities.
AUTHORIZATION TO CONSENT TO EMERGENCY TREATMENT OF MINOR
(I) (We), the undersigned parent(s) of , a minor, do hereby authorize the Buckeye Union School District, as agents for the undersigned in our absence, to consent to X-ray examinations, anesthetic, medical or surgical diagnosis or treatment, hospital care which is deemed advisable by, and is to be rendered under the general or special supervision and upon the advice of any physician and surgeon licensed under the Medicine Act, whether such diagnosis or treatment is rendered at the office of said physician or at any duly licensed medical facility.
It is understood this authorization is given in advance of any specific diagnosis, treatment, or hospital care required, but is given to provide authority and power on the part of our aforesaid agent(s) to give specific consent in any medical emergency to any and all such diagnosis, treatment or hospital care which the aforementioned physician in the exercise of best judgment, may deem advisable. This authorization is given pursuant to the provisions of Section 25.8 of the Civil Code of California. This authorization shall remain in effect until revoked in writing and delivered to said agent(s).
Parents/Guardians (please print legibly):
Mother Name Father Name
Signature of Mother Signature of Father
Date Date
PERTINENT MEDICAL DETAILS REGARDING ABOVE MINOR
Any medical condition that should be called to the attention of the supervisory staff?
[ ] yes [ ] no
If yes, describe:
Any medications taken regularly?
[ ] yes [ ] no
If yes, describe:
PLEASE PRINT LEGIBLY
Home Address:
Home Phone(s)
Cell Phone(s)
Business Phone(s)
Email Address
Family Physician Phone
Person to contact in case of emergency
Address Phone
INSURANCE COVERAGE INFORMATION
It is necessary for the school to have the following information regarding insurance coverage for students participating in the after school sports program.
Student Name
Student Age as of 8/15/10
Grade Room
T-Shirt Size
( ) My son/daughter is covered by one of the school distributed insurance policies.
( ) My son/daughter is covered by a private insurance policy.
Policy Number
Name of Company
This insurance includes injury coverage, which is required for sports participation.
Each runner will receive a team shirt.
Additional team shirts will be available for $10.
Adult team shirts will also be available for $15.
Donation, first shirt included $____
Number of additional youth shirts @ $10 each:
YS YM YL YXL $____
Number of adult shirts @ $15 each:
AS AM AL AXL $____
TOTAL $_____
