Form D - Permission Medical Release Form - California printable pdf download

FORM D -‐ P ERMISSION/MEDICAL R ELEASE F ORM ( 4 P AGES T OTAL)

ALL C ALIFORNIA D ECA S PONSORED A CTIVITIES 2 016-‐2017

CODE O F C ONDUCT

Attendance a t a ny C alifornia D ECA s ponsored c onference o r a ctivity i s a p rivilege. T he f ollowing c onduct p olicies w ill

apply t o a ll d elegates: s tudents, a lumni, a dvisors, a nd a ny o ther a uthorized p ersons a ttending t he a ctivity. T his f orm

must b e s igned b y e ach s tudent a nd a lumni ( under 2 1) a ttending a C ALIFORNIA D ECA a ctivity a nd s ubmitted t o t he

chapter a dvisor p rior t o t he r espective r egistration d eadline. T he c hapter a dvisor m ust h ave a c ompleted c opy o f t he

permission/medical r elease f orm f or e ach s tudent a ttending i n t heir p ossession f or t he d uration o f t he e vent, i ncluding

travel t o a nd f rom t he e vent. T his F orms m ust b e k ept o n f ile i n t he l ocal s chool d istrict a fter c onference.

Delegates s hall a bide b y t he r ules a nd p ractices o f C ALIFORNIA D ECA a nd s chool d istrict p olicies a t a ll t imes t o, d uring,

and f rom t he d esignated p oint o f o rigin o f t he a ctivity. D elegates s hall r espect a nd a bide b y t he a uthority v ested i n t he

CALIFORNIA D ECA o rganization. T he s tandards o utlined i n t his d ocument c onstitute t he C alifornia D ECA C ode o f

Conduct.

The f ollowing s hall b e r egarded a s s evere v iolations o f t he C ALIFORNIA D ECA C ode o f C onduct:

Should a c onduct c ode v iolation o ccur f or i tem 1 t hrough 7 b elow, r egardless o f w hen e xposed, t he v iolating s tudent(s)

will b e s ent h ome a nd w ill n ot b e e ligible t o a ttend a ny o ther s tate, r egional, o r n ational c onference d uring t hat s chool

year. I f t he v iolation w arrants i t, l aw e nforcement m ay a lso b e n otified. D etermination o f p enalties f or v iolations w ill b e

at t he d iscretion o f t he S tate M anagement T eam o r t he B oard o f D irectors/Trustees.

1. Alcohol, D rugs a nd T obacco: a s tudent s hall n ot p ossess, u se, t ransmit, b e u nder t he i nfluence o f, o r s how e vidence

of h aving u sed a n a lcoholic b everage, o ther d rugs, s ubstances o r t obacco p roducts c apable o f o r i ntended,

purported, o r p resumed t o b e c apable o f a ltering a s tudent's m ood, p erception, b ehavior o r j udgment; o ther t han

properly u sed, o ver-‐the-‐counter p ain r elievers a nd m edications p rescribed b y a p hysician f or a n i ndividual s tudent

and m ust b e o n r ecord w ith t he a dvisor. N or s hall t he s tudent p ossess, u se, s ell o r t ransmit p araphernalia

associated w ith d rugs, a lcohol, o r c hemical s ubstance i n a ny f orm ( including t obacco), a t a ny t ime, o r u nder a ny

circumstances, o n p ublic o r p rivate p roperties.

2. Curfew: C ommitting s erious v iolations o f c urfew r egulations a s o utlined i n i tem 9 b elow.

3. Willful C ompanionship: B eing i n t he w illful c ompanionship o f s omeone w ho v iolates a ny p ortion o f t he c onduct

code, o r f ailing t o r eport a ny d irect k nowledge ( other t han h earsay) o f t he c onduct c ode v iolations.

4. Personal C onduct: C heating, d ishonesty, o r t aking u nfair a dvantage o f o thers; p articipating i n s ocial a ctivities o ther

than t hose w ith c onference p articipants; c onducting a cts a nd/or p ossession o f w eapons c apable o f c ausing b odily

harm o r f ear o f l ife, d efacing o r s tealing a ny p ublic o r p rivate p roperty ( for w hich f inancial r esponsibility w ill r est

solely w ith o ffending i ndividuals o r t heir c hapter); b reaking t he l aw; o ther s erious v iolations o f p ersonal c onduct

regulations.

5. Serious V iolations o f t he s tudent c onduct c ode o f t he s chool d istrict o r s chool t hat t he s tudent r epresents.

6. Private T ransportation: D riving o r r iding i n a p rivate a utomobile d uring a c onference, u nless a ccompanied b y a n

authorized a dvisor. ( Delegates a re t o b e h oused a t t he c onference s ite) O ccasionally a c hapter a dvisor, u nder

special c ircumstances, m ay a llow a s tudent t o d rive o r r ide i n a p rivate a utomobile t o a c onference. T hese s tudents

are r equired t o c omplete a " Permission t o u se P rivate T ransportation" f orm t o t he c hapter a dvisor p rior t o t he

conference. P ermission t o d rive/ride a pplies t o t ransportation o f t he s tudent n amed o n t he f orm a nd o nly t o a nd

from t he c onference s ite. O nce a d riving/riding d elegate h as a rrived a t t he c onference s ite, h e/she s hall n ot b e i n a

private a utomobile a gain u ntil l eaving t he s ite a t t he e nd o f t he c onference.

Abusive B ehavior a nd L ewd C onduct: A s tudent s hall n ot e ngage i n a ny l ewd, i ndecent, s exual, o r o bscene a ct o r

expression o r p ossess s uch m aterials. A s tudent s hall n ot e ngage i n v erbal, p hysical o r s exual h arassment, h azing, o r

name-‐calling. T he u se o f s lurs a gainst a ny p erson o n t he b asis o f r ace, c olor, c reed, n ational o rigin, a ncestry, a ge,

sex, s exual o rientation, o r d isability i s p rohibited.

CA D ECA L ACE C onference 2 016

Form D -‐ P age 1 o f 4

Form D - Permission Medical Release Form - California

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