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Cassville R-IV School District

Middle School


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Extra-Curricular Handbook







PURPOSE:  The purpose of the extracurricular program is to provide an experience that enables the pupil to progress toward established educational objectives.  Outlined below are some of the desirable educational goals to be achieved through the competitive programs.




      1.   Qualities of mental and physical strength, endurance, vitality, and neuromuscular


  1. A program of activities that meets the needs, interests, and capacities of the student.
  1. Qualities of alertness, courage, resourcefulness, and good sportsmanship.
  1. Proper emotional control and stability of character.
  1. Desirable social patterns of individual and group conduct.




  1. A program of extracurricular activities as an integral part of the school curriculum.

      2.   A high standard of school loyalty, pupil morale, and wholesome school spirit.

  1. Student understanding of extracurricular activities so that they will be more

      intelligent and appreciative as spectators.




An understanding that the extracurricular activities for pupils has been promoted under conditions which insure to the participant and to the public, the best traditions in sportsmanship, citizenship, and a wholesome school community relationship.





OBJECTIVES:  Participation in extracurricular activities means much more than two teams trying to win a contest.  Extracurricular activities give the student tremendous opportunities to develop as a “complete” human being.  Here at Cassville we have specific objectives for our activity program, and we as sponsors dedicate ourselves to reaching these objectives.  By the time a young participant graduates from Cassville High School we want him/her to be able:


  1. To work cooperatively with others.

      2.   To learn from constructive criticism.

  1. To have self-confidence in stressful situations.
  1. To discipline himself/herself.
  1. To feel proud of the great Cassville tradition.
  1. To lead others.
  1. To teach certain skills to younger participants.
  1. To respect teamwork, organization, and unity.
  1. To appreciate the help that parents, teachers, coaches, and administrators have given them.
  1. To represent Cassville Middle School in a positive way.
  1. To evaluate his/her abilities realistically.
  1. To have a positive learning attitude toward all tasks.
  1. To value hard work and what hard work accomplishes.
  1. To seek help from others when a problem arises.
  1. To develop lasting relationships with others.
  1. To praise others who do a good job even though they may be opponents.
  1. To be physically fit and healthy.
  1. To respect the rules and the officials who enforce the rules.

     19.  To feel good about himself/herself as a person.

  1. To be dependable when given a job to do.



  1. Opportunity to participate in an activity that parallels many later life experiences.
  1. Opportunity to develop physical, mental, and social powers to the fullest.
  1. Develop responsiveness to group discipline.
  1. Develop lasting relationships.
  1. Develop self-confidence.
  1. Develop respect for rules and duly constituted authority.
  1. Opportunities for development of cooperation, resourcefulness, perseverance,

      sportsmanship, gameness, initiative, and unselfishness.

  1. Travel opportunities enable you to see other communities and get acquainted

      with other types of people.

  1. Competition experiences tend to make one more friendly, interesting, and human.
  1. Increase your circle of friends and acquaintances.
  1. Draws attention to you, which may have a “business” value later on.
  1. Successful participation may open the door to future vocational opportunities.
  1. Abilities gained through participation have helped many students through college.



  1. You may practice and never make the “team.”
  1. Participation rules may cramp your “social style.”
  1. You will have to stay after school night after night for four or five months a year.
  1. Less study time available, yet you must pass your subjects to be eligible.
  1. Hard, tiresome, and sometimes monotonous repetition of certain activities.
  2. Possibility of physical injury in athletics.





The seventh grade level is an important level to attempt to play everyone to promote a sport.  At times this may be difficult because of the large number of team members and shorter quarters.  Coaches will make every effort to play everyone based on hard work, desire, dedication, and commitment the player has demonstrated.  If tournaments are played at the end of the season, the coach will decide on who plays and how much.  Efforts to schedule extra games and quarters will be made throughout the season.


The eighth grade level is also an important level to promote a sport.  More emphasis is placed on winning; however, every effort to play everyone will be made depending on the game situation and the commitment players have made to themselves and teammates.  Efforts will be made to schedule extra games and quarters to give those players deserving the opportunity to play.




Students who represent Cassville Middle School in extracurricular activities are expected to be good citizens.  Participation in extracurricular student activities is a privilege and not a right.  In order to maintain the highest possible standards for participants in the Cassville Middle School system, the following minimum requirements are established for all students participating in the activity program.  More restrictive standards may be required by each individual sponsor/coach.  These citizenship standards apply to students three hundred and sixty-five (365) days a year and twenty-four (24) hours a day, regardless of whether a student is on campus or off campus.


A brochure entitled “How to Protect and Maintain your High School Eligibility” from the Missouri State High School Activities Association (MSHSAA) is provided for your review.  This brochure provides useful information concerning common situations that cause students to lose eligibility both during the school year and during the summer months.  Please take time to read this document.





Prior to participating in any activity, or practice leading up to an activity, students must have the following documentation on file in the principal’s office:


  1. Physician’s Physical form including student’s verification of health insurance (completed after February 1 of the previous school year) *This applies only to students participating in athletics.
  2.  Drug Testing Form/ Parent Permission Form/Activity Handbook Form/Big 8 Sportsmanship Creed (included)




All MSHSAA governed activities including:  All sports, cheerleading, band, vocal music, speech/debate and the academic team.



  1. The student must have been promoted to a higher grade or higher level in special education at the close of the previous year.  This eligibility requirement becomes effective after the first quarter of the seventh grade year. 
  2. A student who is academically ineligible during the current quarter, but meets the academic standard at the close of the current quarter, becomes eligible the fifth day classes are attended in the following quarter. 
  3. The student shall be enrolled in and regularly attending the normal courses for that grade or must be enrolled in a full course in the public school special education program.
  4. A student shall be ineligible to participate in extracurricular activities if he/she has reached the following ages prior to July 1 preceding the opening to school:  Grade Seven – age 14 and Grade Eight – age 15.
  5. Students who represent Cassville Middle School in extracurricular activities must be credible citizens and judged so by the proper school authority certifying the students.  If students are found to be “non-credible” then they will not be allowed to participate in extracurricular activities.
  6. Students receiving more than one failing grade (<60%) for a quarter will be considered academically ineligible for a minimum of 3 weeks.  During that time the student will be able to improve the grade(s) before re-evaluation.  Student eligibility will be determined only for the failing grades received on quarter / semester reports.  During a period of ineligibility, a failing grade in a different subject received on an interim grade check will not affect student eligibility status. 
  7. Eighth grade students failing 2 or more classes for the last semester of their 7th grade year will be ineligible for the first 3 weeks of their 8th grade year.  If these students are passing all classes at the end of the 3 week cycle, they will become eligible.  Seventh grade students will remain eligible until the first reported evidence of failure in more than one class on a quarter or semester grade report. Ineligible students may continue to participate in practice at coach/sponsor discretion. If they have met the above requirements at the next grade check, they are immediately eligible for extracurricular contest, at the coach/sponsor’s discretion.
  8. The following dates are the scheduled grade checks for each quarter…

1st September 6                September 27              October 4  (last day of 1st qtr)

2nd October 24                  November 15              December 20 (last day of 2nd qtr)

3rd January 24                   February 14                 March 6 (last day of 3rd qtr)

4th March 27                     April 17                       May 15 (last day of 4th qtr)





  1. Students are required to attend school the day of a contest, unless prior

      arrangements have been made with the principal.

  1. A practice or game should not be missed unless previously excused by the sponsor of that particular activity. 



  1. On trips, participants directly represent the community, school, and coaches/

         sponsors.  Therefore, it is expected that all concerned will dress in an acceptable manner when traveling and conduct themselves in a manner that will not bring discredit             to Cassville Middle School and the community. 

  1. All participants are expected to travel to contests with their group and sponsor.  If unusual circumstances arise in which a student cannot ride to a contest with their group, prior approval must be sought from the principal/athletic director.  Coaches/sponsors may permit students to travel home from contests with parents. (These situations require that parents sign their child out after contests, or send a note for prior approval from the athletic director/principal to allow their child to ride home with other parents).  Under no circumstances will students be allowed to ride home from activities with other students.


Failure to follow these expectations will result in suspension of further travel privileges (the degree of suspension will depend on the severity of the offense and will be determined by the sponsor/coach and the building principal).






  1. Students are not allowed to participate in “open gyms”, as well as other non-school competition in another sport, on the same day they are participating in a school-sponsored extra-curricular sports activity without permission from the head coach of the sport in which they are currently participating and the building principal.
  2. Students may participate in activities such as band, vocal music, speech/debate, etc. during their sports seasons.  From time to time, conflicts may arise where events are scheduled for both activities during the same time.  Students are asked to look ahead at potential conflicts in schedules and let their sponsors/coaches know of these situations as early as possible.
  3. A student who wishes to participate in two sports during the same season must obtain a consent form from the athletic director and follow guidelines set down by the athletic department.




Participants will not be allowed to quit one activity to join another activity within the same season after 3 days of practice without approval from both coaches/sponsors.  Also, students will not be allowed to quit an activity of one season to begin an activity of the next season until the first season is complete without both coaches/sponsors’ approval.




Student violations of the school district’s citizenship standards include:

  1.   Repeated referrals for disciplinary action to the assistant principal/principal.
  2. A single breach of the school district’s discipline policies that the administration considers to be serious. 
  3.  A violation of federal, state, or local criminal law that results in a summons being issued to the student, or charges being filed in court against the student proved to the satisfaction of the administration (minor traffic violations are not included).
  4. Failure to follow the sportsmanship expectations established by the school, the

Big 8 Conference and the MSHSAA, which include but are not limited to the


  • Show respect for the opponent at all times.
  • Show respect for your coaches/sponsors and officials.  Never argue or make gestures indicating dislike for a decision.
  • Maintain self-control at all times, accepting decisions and abiding by them.
  • Accept both victory and defeat with pride and compassion, never being boastful or bitter.
  • Congratulate the opponents in a sincere manner following either victory or defeat.
  • Accept the responsibility and privilege of representing the school and community in a positive manner.
  •  Possession, use, sale or transfer of tobacco products, alcoholic beverages, controlled substances or drugs, as defined in the student discipline policy and board policy, at any time or location, proved to the satisfaction of the administration. 
  • School uniforms and equipment are not to be worn other than during practice or during games.  Participants are responsible for equipment that is lost or damaged.  All equipment that is not returned, such as jerseys and practice gear, must be paid for by the participant. 
  • Any participant serving OSS is not eligible to practice or participate in activities during their suspension.  Any student assigned to ISS is not eligible to participate in activities for the same number of days as the assignment beginning the day ISS is assigned.



The penalty for these general citizenship standards may vary according to the seriousness of each offense.  Penalties may range from reprimands from the sponsor/coach to permanent suspension from further participation in extracurricular activities.  The sponsor/coach will confer with the building principal to determine the amount and type of penalty assessed. 



Use and Possession of Tobacco/E-Cigarettes / Vaping devices


Students participating in extra-curricular activities are expected to refrain from the use and/or possession of tobacco, E-cig. or vaping device regardless of whether the student has reached the legal age (18) to purchase such products. 


First Offense – On a student’s first violation, he/she shall be suspended for the next activity/game.

Second Offense – On a student’s second violation, he/she shall be suspended for remainder of the activity season.

Third Offense – On a student’s third violation, he/she shall be suspended from all activities for the remainder of the school year.


Involvement in more than one program during the punishment period will result in suspension from each activity.

Violations involving the use and/or possession of tobacco do not accumulate from one year to the next.


Use and Possession of Alcoholic Beverages and Drugs


Students are expected to refrain from the use and/or possession of any beverage containing alcohol, as well as any substance (marijuana, cocaine, anabolic steroids, and other drugs) defined by the law as an illegal drug, unless specifically prescribed for the student’s own use by his/her physician.  Violations include the following:


  1. Alcohol, intoxicating liquor as defined in Chapter 311, RSMo, or alcoholic beverages
  2. Controlled substances, counterfeit substances or imitation drugs as defined in Chapter 195, RSMo.
  3. Solvent, or toluol, as defined in Chapter 578, RSMo.
  4. Controlled substance analogue as defined by Chapter 195, RSMo, and any substance which has a chemical makeup similar to any controlled substance, as defined above, and which when ingested or otherwise used causes a condition such as intoxication, euphoria, dizziness, irrational behavior, stupefaction or hallucination.
  5. Anabolic steroid or other similar compound that is derived from testosterone or prepared synthetically.
  6. Drug paraphernalia as defined by Chapter 195, RSMo.
  7. Prescription medications that are not prescribed to the student.
  8. Prescription medications that are prescribed to the student (If the student sells or distributes the medication to others).



First Offense – On a student’s first violation, he/she shall be suspended for one-half of the activity season.  The student will be removed from any office he/she holds in any club or activity.

The length of this suspension may be reduced to one-third of the activity season if the student voluntarily seeks a minimum of five (5) hours of counseling that specifically addresses alcohol and/or drug abuse.  Parents of the student would be responsible for the costs of this counseling, as well as providing documentation to the building principal concerning successful completion of the required hours of counseling.

Second Offense – On a student’s second violation, he/she shall be suspended from all activities for 365 days.

The length of this suspension may be reduced to 180 days if the student voluntarily seeks a minimum of fifteen (15) hours of counseling that specifically addresses alcohol and/or drug abuse.  Parents of the student would be responsible for the costs of this counseling, as well as providing documentation to the building principal concerning successful completion of the required hours of counseling.


Third Offense – On a player’s third violation, he/she shall be permanently suspended from co-curricular/extracurricular activities.

In keeping with our philosophy of encouraging honesty and proper values, students who are arrested or charged with violations of criminal law must inform the coach, athletic director, or the building principal within seven days of being arrested or charged with the criminal act.  Failure to do so will result in suspension for an entire activity season.




Penalties and violations for all citizenship violations shall accumulate beginning in the 7th grade and will carry over through the 8th grade. 


All suspensions occurring at the end of activity seasons will carry over to the next activity season.  Involvement in more than one program during the punishment period will result in suspension from each activity.


Suspensions for students in the 8th grade will only be applied to activities the student has previously participated in the 7th grade.  (For example:  Students would not be able to serve a suspension in a sport/activity they had not previously participated in to avoid being suspended from another sport/activity).  8th grade students would serve their suspensions in the next sport that they participate in at the HS level.







Athletic Director

Doug Martin


Shari Rhea – Head Coach

Erin Flehmer – Asst Coach


Brian Barbee – Head Coach

Chris Fortner – Asst Coach

Nathan Fortner – Asst Coach

Collin Pearman– Asst Coach

Boys/Girls Cross Country

Chris Shore – Head Coach

Courtney Beagle – Asst Coach

Girls Basketball

 Chris Shore– 8th Grade

 Kristi Pinckard– 7th Grade

Boys Basketball

Josh Schmitt – 8th Grade

Chris Shore – 7th Grade


Brian Barbee

Chris Fortner



Kristi Pinckard – Head Coach

Janet McNiell – Asst Coach


Tina Mills – Girls

Mark Elliott – Boys

Courtney Beagle – Asst Coach


Tina Mills

Knowledge Bowl

Leigh Martin

Vocal Music

Dustin Surber


Erica Gorman





Policy Statement – As a part of the educational curriculum of this District, the Board believes that all students should be encouraged to remain drug and alcohol free in their personal lives.  The Board further believes that it is the District’s responsibility to create an educational atmosphere which promotes freedom from use of drugs and alcohol, encourages students to resist peer pressure, establishes high standards of personal conduct, provides a sense of order in the school and at school activities, supports laws which prohibit the use of drugs and alcohol, and provides parents with support in raising their children to be drug and alcohol free adults and citizens.


Application of Policy Goals and Objectives to School Environment – Students who represent the District in competitive extracurricular activities are leaders in the school environment.  Participation in these extracurricular activities is a privilege and not a right, and it is essential that these student leaders uphold the highest possible standards of conduct as role models for the rest of the student body and as representatives of their school and community.  A properly administered drug-testing program for all students who represent the District in competitive extracurricular activities will promote these goals and objectives.


Definitions – The terms are defined for purposes of this Policy:


Competitive Activities” – means any school-sponsored extracurricular activity in which a student represents the District, in the opinion of the District’s Administration.  Competitive Activities include all Missouri State High School Activities Association (“MSHSAA”) regulated activities and events such as athletics, band, choir, speech and debate, cheerleading, and academic competition.


Competitive Activity Season” – means the period of time specified by the Missouri State High School Activity Association, the District, or some other governing body, as the time during which the Competitive Activities may be conducted.  This time period shall be further defined to begin with the first scheduled competition and end with the last scheduled competition and shall not include training time which is allowed prior to the first competition.


Consent Form” –  means the Parent/Guardian Drug Testing Consent Form which is adopted by the District’s Administration.


Contests” – means the scheduled games, matches, or contests (including District, Sectional and State contests) for any Competitive Activity.


Controlled Substance”  – means any substance listed in Section 195.010 RSMo and Schedules I through V of Chapter 195, RSMo.  Examples of such substances include, but are not limited to, marijuana, hashish, cocaine, crack, amphetamines, methamphetamine, barbiturates, opium and heroin.

Deadline Date” – means the third Friday following the first day of classes in the District each school year or by the date of the first contest in an activity which the Participant participates, whichever comes first.


Drug” – means any controlled substance or other drug which requires a prescription which the Participant does not possess.


Drug Test” – means a validated method to test for the presence of controlled substances and drugs in a person’s urine.


Participant” – means any student in grades seven through twelve who participates (or desires to participate) in Competitive Activities and/or signs up for such activities.

Procedures for TestingConsent Forms


In order to participate in Competitive Activities, a Participant must provide the District with a signed Consent Form.  The Consent Form will be distributed at the beginning of the school year and must be signed and returned no later than the Deadline Date, regardless of when the student will participate in the Competitive Activities.


The Consent Form will be provided to students who enroll after the first of the school year.  Students must submit the signed Consent Form within two weeks following his/her enrollment date.  These Participants may also be subject to immediate Drug Testing.


Any student who fails to return a signed Consent Form by the Deadline Date will be subject to the following criteria:


The student will be prohibited from participating in any competitive activity during the school year, or


Should the student choose to sign the consent form after the deadline date, the student would be required to serve a suspension equal to one-third of the competitive activity season.


Procedures for TestingRandom Selection


Each Participant who has returned a signed Consent Form will be assigned a random number for testing purposes.  The Participant’s Drug Test number will be used by the laboratory which conducts the Drug Tests to refer to the Participant.  In order to assure privacy, the name of any student who is tested shall be known to District Administrators only on a “need to know” basis.


The selection procedure shall be performed by the laboratory testing personnel who are used by the District.  Selection of the Participants for each Drug Test shall be accomplished by random sample of all Participants.  The selection process will follow scientifically accepted random sampling techniques.

Each quarter during the school year approximately ten percent (10%) of the Participants will be selected to take the Drug Test.


Procedures for TestingDrug Test and Test Result Reporting


Participants who are selected by random sample will be asked to provide a urine specimen. 


In order to assure privacy, the specimen shall be collected in a private restroom facility behind a closed stall.  The process will be supervised by trained personnel who will remain outside the stall.


The specimen will be observed for normal characteristics to insure the validity of the test.


A routine chain-of-custody protocol will be observed with respect to the specimen.

A screening test will be performed on the specimen by trained laboratory personnel.  If the screening test is positive, it will be considered a “non-negative” test result.  Every effort will be made to insure that no person, other than appropriate District Administrators or personnel, knows the identity of any Participant who produces a “non-negative” specimen.  A confirmation test will be run on all “non-negative” specimens.  If the confirmation test is positive, the designated laboratory personnel will notify the designated District Administrators that a positive result was obtained. 


The designated District Administrator will contact the parent or guardian of any Participant who has a positive test result.  If the student/parents assert that the positive test was caused by something other than the consumption of an illegal substance, the student/parents will have 72 hours to produce evidence to the medical review officer.  This evidence should include a list of all substances, along with the appropriate prescriptions that the student may have taken prior to testing.


The District will rely on the opinion of the laboratory’s medical review officer with respect to the validity of the specimen, the cooperativeness of the Participant during the testing procedure, the results of the drug test, and any additional information provided by participant/parents. 




A Participant whom test positive on a Drug Test administered under this Policy shall be subject to the following penalties:


1.         First Positive Result – The Participant will receive a citizenship suspension for one-half of the Contests during the Competitive Activity Season in which the Participant was participating at the time of the Drug Test or the next Competitive Activity Season in which the Participant intends to participate, whichever comes first.

If the positive result comes after more than one-half of the Contests have been completed, the remainder of the suspension will be applied during the next Competitive Activity Season in which the Participant is engaged.  The length of this suspension may be reduced to one-third of the Contests if the Participant voluntarily seeks a minimum of five (5) hours of counseling that specifically addresses alcohol and/or drug abuse.  Parents of the Participant are responsible for the costs of this counseling, as well as providing documentation to the building principal concerning successful completion of the required hours of counseling.  The Participant may also be removed from any elective or appointive office he/she holds in school, school club, or competitive activity. 


2.         Second Positive Result – In the event the Participant receives a second positive test result at any time following the first positive result, the Participant will receive a citizenship suspension from all Competitive Activities for three hundred sixty-five (365) days.  The length of this suspension may be reduced to 180 days if the student voluntarily seeks a minimum of fifteen (15) hours of counseling that specifically addresses alcohol and/or drug abuse.  Parents of the student would be responsible for the costs of this counseling, as well as providing documentation to the building principal concerning successful completion of the required hours of counseling.  


3.         Third Offense – The Participant will be permanently suspended from all Competitive

Activities for the remainder of his/her time in the District.


Each Participant who is suspended from extracurricular activities because of a positive drug test will be required to pass a drug test administered by the Cassville R-IV School District’s testing service prior to being reinstated to Competitive Activities.  After passing a drug test and being reinstated, the Participant will be placed back in the testing pool and will be eligible for random testing.


All Participants are expected to cooperatively participate in the procedures set forth in this Policy.  A Participant, who refuses, by word or actions, to cooperate with a Drug Test conducted under this Policy, in the opinion of the personnel conducting the Drug Test, shall be treated as if he/she had a positive test result of a Drug Test and will be subject to the consequences described in the drug testing policy.


A Participant who engages in conduct which gives the District or personnel conducting the Drug Test the reasonable belief that the Participant has (or has attempted to) alter, adulterate, modify or change any specimen, Drug Test or Drug Test record, shall be treated as if he/she had a positive test result of a Drug Test and will be subject to the consequences described in the drug testing policy.


Appeal Procedure – If a Participant receives a suspension from Competitive Activities pursuant to this Policy, the Participant may appeal the decision in writing to the Superintendent and the Board of Education.  The Participant’s written appeal shall be reviewed and a decision shall be rendered within five (5) working days following the date the written appeal was received by the Superintendent.





Interscholastic activities shall supplement the curricular program of the school and shall provide the most worthwhile experiences possible.  These experiences shall result in learning outcomes that contribute to the development of the attributes necessary for good citizenship.  To this end only can interscholastic activities be justified.


Respect for Opponents

The opponent should be treated as a guest, greeted cordially upon arriving, given the best possible accommodations, and accorded with tolerance, honesty, and generosity.

Respect for Officials

Officials should be recognized as impartial arbitrators who are trained to do their job and who can be expected to do it to the best of their ability.

Knowledge and Understanding of the Rules

Familiarity with the “current” rules of the game and the recognition of their necessity for a fair contest are essential.

Self Control

Good sportsmanship requires one to understand his/her own bias or prejudice and the ability to prevent the desire to win from overcoming rational behavior.

Appreciation of Skill in Performance

Applause for an opponent’s good performance is a demonstration of generosity and goodwill that should not be looked upon as treason

Responsibilities of Students and Parents

Students and parents frequent role as spectators and their enthusiasm for sports indicate a vital responsibility for good sportsmanship.  Their habits and reactions determine the quality of sportsmanship, which reflects upon our school. 

Students and parents are expected to:


*Know and demonstrate the fundamentals of sportsmanship

*Respect, cooperate, and respond to cheerleaders.

*Respect school property and authority.

*Show respect for the opponent.

*Show respect for injured players.

*Respect the judgment and strategy of the coach.

*Respect the judgment of game officials.

*Avoid profane language and obnoxious behavior.

*Not applaud errors or penalties of opponents.

*Not heckle, jeer, or distract opponents.  This includes distracting behavior during the shooting of free throws by opposing players.

*Not criticize players, coaches, or officials for a loss.

*Not stomp on bleachers (Also forbidden by MSHAA rules).

*Not throw objects onto the playing area or in the bleachers.

*Not use noisemakers of any kind.

*Not use cheers that taunt or ridicule the opponent, their cheerleaders, or spectators.

*Not boo or show overt displeasure with game activities or game officials.




(Please fill out and return the following permission form to your coach)



Extracurricular Activity

Random Drug Testing Consent Form

Cassville R-IV School District


The Cassville R-IV School District recognizes the importance of a drug free life; therefore, the District has adopted an Extracurricular Random Drug Testing Policy.  We have read and understand the Cassville R-IV School District’s Extracurricular Random Drug Testing Policy. We understand the purpose behind this policy, and we agree to abide by the procedures and consequences of the policy.  We authorize the release of information from the drug testing laboratory to the Cassville R-IV School District.


_________________________________________              ______________________

                            Student Name                                                                 Grade


_________________________________________              ______________________

                          Student Signature                                                              Date


_________________________________________              ______________________        

      Parent or Guardian Signature                                                    Date             






     I give my consent for this student to represent Cassville Middle School on activity trips

without holding Cassville R-IV Schools or trip sponsors responsible in case of accident or injury.

     I give permission for accompanying sponsors to provide or cause to be provided any emergency medical attention as deemed necessary.  I understand that I will be notified in the event of any emergency situation as quickly as possible.

     This permission and authorization is valid for the period of July 1, 2019 through

August 31, 2020. In addition I understand that by signing this form I am agreeing to abide by the policies set forth in this manual and I will also abide by the Big 8 Conference standards as well.


Student Name_______________________________________________

Student Signature____________________________________________


Parent Name________________________________________________

Parent Signature_____________________________________________