WELCOME
You are very welcomed into The Husky Marching Band. Your contributions are eagerly
awaited and anticipated. Please note that the success of the marching band relies on your
energy, enthusiasm and preparedness. We come from a variety of backgrounds and diverse
degrees of musical experience. My responsibility to you and the entire band is to provide the
best experience that can collectively be created. Therefore the primary purpose of this
handbook is to serve as an operational guide for all stakeholders of our band program.
This handbook is a systematic approach to the teaching and organization of the marching
band and is designed to help avoid costly delays and loss of time due to a lack of awareness
of policy and procedures. Whenever questions arise, please consult the handbook. If your
question is not answered feel free to email me at [email protected]. Please
keep this handbook with other handouts that involve band activities for easy reference.
Congratulations for making the BEST choice and becoming a cadet in the Husky Marching
Band. It will be a pleasure to serve you and I certainly look forward to working with each of
you as we create an amazing year.
Robert Carrington
Director of Bands
PURPOSE OF MARCHING BAND
The Hough High School Marching Band is an organization that is comprised of talented
students from the student body. Members of the band are a disciplined group of students
who are proud to support their team during the school year, as well as represent Hough High
School throughout the state in various competitive and community service venues. Members
of the marching band devote a great deal of time and effort to building interpersonal
relationships, increasing their musical abilities and working together in a team-building
manner with the goal of achieving outstanding results throughout the year.
A STATEMENT OF POLICY
In order to assist band members and parents in understanding areas of responsibility, a statement of
band policy is herein set forth. Becoming familiar with this policy will enable each band member to
make the most of this great opportunity to become a better person and a better musician.
“We believe that music education is a catalyst, more unique than any other discipline, which
contributes to the positive growth and development of young people. The musical ensemble is a
micro-world in which people of different races, creeds, and abilities unite through hard work, mutual
respect, dedication and individual commitment to achieve a common goal of excellence. We firmly
believe that students should strive to improve their musical skills through regular practice. In the
Hough High School Band Program, we feel that the happiest students are the ones who are improving
themselves through regular habits of practice and daily progress. They must not only know right from
wrong, but must be able to stand for their principles. They must develop a high sense of purpose. We
intend to conduct the Hough High School Bands in a manner that will facilitate all students in learning
and bettering themselves while providing a strong vision for the school and community."
WHAT IS THE MARCHING BAND OF TODAY?
The excitement of watching a marching band perform is something that many people have had the
privilege to experience. Anyone can be in an audience to experience musical achievement. However,
few people participate in the task of creating that ensemble. The growth that is seen in any
performance is the result of many different facets to the development of the ensemble and more
directly to the development of the individuals in that ensemble.
Generally, a marching band rehearses music to the point of memorization, learns how to march in a
specific style with an instrument, coordinates with others to create drill patterns and maneuvers and
learns to adapt quickly to changes that need to be made at a variety of speeds. Marching Band is
indeed a sport that not only requires agility and support, but also comprehension for improvement as
well as tenacity.
There are several areas where marching band benefits the high school student. It helps further develop
the mastery of a band instrument or a piece of equipment. As the most visual performing ensemble, it
allows the opportunity for multiple performances throughout the year. Students are exposed to a
variety of genres of music from classical to rock. Playing in the marching band also develops the
abstract concept of musical expressiveness. It develops pride within the school through the
participation at football games and contests. In fact, the marching band reflects many of the positive
attributes of the high school in general. Finally, marching band has many residual effects through the
development of responsibility and leadership. By striving in a coordinated endeavor each student
gains confidence, charisma and becomes a part of a musical family.
The marching ensemble of today bears little resemblance to its precursor of yesteryear. In essence the
marching band of today is more challenged and highly competitive. With the rise of Drum Corps,
Winter Percussion and Winter Guard, the marching ensemble has become a highly developed and
instructional class construct. Dedication and expectations of performance are extremely high.
Therefore rehearsal and practice make the difference in a successful marching ensemble.
When asked why one should join the marching band, many participants find it hard to put into words
because the feeling one gets through performing, working with others, developing friendships and
rushes of adrenalin are unimaginable. Because of all these benefits, Hough will have an outstanding
music program. The marching band will be in the forefront of that development.
THE TOTAL EFFORT
In order for the Hough Band Program to be the best band program, we must forgo the luxury of
making excuses or letting problems go unresolved. Playing problems are going to occur in every
rehearsal. The manner in which they are corrected will ultimately determine the success we experience
on the field. When things go wrong, devote your efforts to trying to REMEDY the situation rather than
trying to place BLAME. Rehearsals will move smoothly and efficiently if we decide to work together
toward the common goal.
Everything you do becomes a vital element in the success and character of our performances.
Remember, any movement that is not consistent with the rest of the band will distract the audience.
Your total concentration during rehearsals and performances will insure precision and style while
playing, which benefits our organization. It is important that you will begin each performance as well
prepared as humanly possible. Always add that final touch of mental alertness that can make your
performance great. Do not sell yourself short or insult the band's integrity by doing anything less.
Remember: A chain is only as strong as its weakest link.
RESPONSIBILITIES OF A BAND MEMBER
As members of this organization, we have many aspirations, activities and responsibilities. It is
essential to any program to be sure the duties and rewards of the program are coordinated to be sure
our goals are met.
To Ourselves: You have the primary responsibility of developing your own abilities. The benefit
of a good playing instrument and private instruction can never be underestimated. What you put
into your performance is what you will get out of it. Mr. Carrington is always available for musical
encouragement and guidance.
To The School: Hough High School and Charlotte Mecklenburg Schools provide us with very
basic funding, equipment, and facilities for a band program. The Band Booster Club provides
additional funding and support for special activities. We have the responsibility to provide the best
possible service for their investment.
To Music: Music has always been a part of our culture. We must take what we have and use it for
the betterment of that culture. No one expects all students to be virtuoso musicians, but to make a
positive contribution to the process of preparing and performing music.
To Each Other: We must always do what is best for the welfare of the entire group. There can be
no selfish acts. We must respect each other! If there are conflicts, find a way to resolve them.
Never insult or degrade another band member. Since we are all in this together, we must work
together as a team.
Financially: The band is funded by the school district to cover the basic essentials. In order to be
fully functional and have the opportunity to attend special activities a band lab fee is assessed.
Students must also participate in fundraisers. Individual accounts are kept for each student and
records are kept of how much profit each student generates.
COMMUNICATION AND CHARMS
Communication is the key to the success of any student and/or band program. There
are several ways in which we promote communication. We have a band website that
had most information needed for parents and students alike. Please be mindful that as
events evolve throughout the year, all information on the website should be considered
tentative. The best way to directly communicate with Mr. Carrington is through email
at [email protected]. We also utilize an office assistant program called
Charms. This is an amazing technological resource that is used to inform families of
band activities through email and newsletters as well an update on the student’s band
account. The school system provides access to its online grading system that can keep
you informed of your student’s academic progress in marching band. You can also
leave a message on Mr. Carrington’s voicemail by calling the school at 980-344-0514.
Please understand that directing an outstanding program such at Hough requires much
time and effort. It is not possible to always give an immediate response but every
attempt will be made to return your inquiry within 48 hours. Once your band student’s
school identification number had been entered into to charms, you may access their
account. It is the responsibility of the family to keep their information current in
order to receive information regarding band activities. You will have to enter email
information into charms and keep it regularly updated.
PERFORMANCE POLICIES
(Competitions, Games, Practices, Bus)
In general, all band activities are school related; therefore, school policies and guidelines will be
enforced including:
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No weapons of any kind
Use of drugs, alcohol, or tobacco products is prohibited
No profanity in language or clothing
No displays of inappropriate behavior that might be an embarrassment to the band or
school
Infractions will be dealt with not only by Mr. Carrington, but also through the school
administration. Let us always keep in mind that we want the Hough High School Marching Band
to be well respected in our community.
Rehearsal Expectations:
Because of our limited time together, it is important
that each member understands and executes proper procedure during a rehearsal.
Regular rehearsals begin at 5pm and end at 8pm. This means the rehearsal begins and
ends on the practice field. This does not include getting your instrument out and
heading to the field. A good rule of thumb is to arrive 20 minutes early in order to be
on time. A typical rehearsal period will begin group stretches on our practice field.
Both leadership teams will be given an agenda for the rehearsal. Each student must be in
their spot with all materials needed for a marching rehearsal. Students who fail to be
ready on time will be disciplined accordingly and will have their grade lowered. When
not being used, instruments are to be clustered by sections to avoid damage and loss.
Students are not to play on another student’s instrument. Students will be held
financially responsible for any damage to school equipment. The drum majors will
begin the rehearsal. It is customary that students observe and follow instructions the
first time they are given. Students are expected to work to improve during the rehearsal.
All members must give active participation in order to achieve success of our program.
The director will make every effort to end the rehearsal by the proper time. Students are
then expected to leave the field and facilities in a clean and appropriate fashion. The
student is to make sure to put all equipment away properly.
Football Game Expectations:
On most days of football games the marching
band stays after school in order to take advantage of last minute corrections that need to
be made in performance. Students are expected to report to the appropriate rehearsal
site on time. This may mean that you may have to plan ahead in order to be prepared
and to have materials brought with you to school on game days. Students will not be
allowed to leave campus on their own at any point when in our care. Upon the
conclusion of the rehearsal students will be given an opportunity for down time and an
evening meal. Our booster organization will provide a general meal. Payment for these
meals will be handled by the booster organization. Students with special diets or who
do not wish to eat the meal provided are encouraged to bring their own meal. If the
student brings food to school a refrigerator will be made available. In addition, a table
will also be made available after school where parents may drop off a meal to their
student manned by a booster volunteer. Because timing of the activity is vital students
may only eat during the time scheduled as they will be responsible for other activities
before and after.
A departure time will be established for away trips. Games at home will generally
operate in the same fashion. Band members will report to the band room to receive
final instructors and/or rehearse before the game. We then line up in the hallway
between the band room and gym. Pit equipment and other pertinent items will have
been loaded by this point and we will march towards the stadium. Once attention is
called the performance begins. Once in the stadium we will perform our pregame show
which includes the national anthem. We will take the field jointly with the ROTC
leading.
Once our pregame show has concluded we march to the stands. We will dismiss by
section in order expedite our placement in the stands. ALL PERFORMERS will be
given a specific place to sit/stand. You are to remain in that spot and not to move
around the block. Although students find much enjoyment in the social aspect of the
football game, we provide a functional purpose which is why we get in free. Band
students should get involved in the football game and support our team using good
sportsmanship. You must have permission from professional team members in order to
leave the block.
Before the end of the first half we will leave the stands in order to prepare for our halftime performance. Students are expected to move quickly and to listen to instructions
given the first time since time is of the essence. Upon the conclusion of our
performance students will be released for Third Quarter Break. Students must stay on
the home side unless given permission by Mr. Carrington. If you are in full uniform be
mindful that any damage to the band uniform may be very costly to you. You are not to
run at anytime. All members will be required to return by a specific time on the clock.
You must BE IN PLACE at that time. Exceptions will be made if there are unusual
circumstances as deemed by Mr. Carrington. Students who violate this expectation will
lose the privilege of Third Quarter Break.
At the completion of the game we will load up and line up on the track in front of the
home stands and march back to the band room. Once in the band room all students will
change out of uniform and help return equipment and facilities to their appropriate
space and state. Parents who wish to pick their children up in a timely manner are
encouraged to help the students and boosters with the unloading of equipment. We will
have roll call before dismissal to guarantee all aspects have been handled appropriately.
Roll call in handled privately without booster or parent inclusion.
Away games are slightly more involved. The departure time will be determined on the
distance traveled and the start time of the game. A tentative return time will also be
posted but cannot be guaranteed as football games are of varying length. Students will
be allowed to call their parents to inform them of the arrival time as soon as we load the
bus to return to Hough.
Competition and Parade Expectations:
On Competition Days we will
rehearse before we leave. The only exception is for students taking the SAT.
Procedures at school operate similarly as football games. Students must be focused as
this is our “game-day” process. Please refer to the travel expectations below regarding
bus expectations. When we arrive at the competition site students are expected to be
SILENT until we disembark. Once we unload students will make two lines based on
gender to go to the restroom. A chaperone will escort the groups to the restroom.
Students will walk in a line to and from the restroom. Students and booster volunteers
will unload equipment and we will prepare for the performance process. Pluming and
Gloving will occur at some point. Students are not to handle the plumes and should
take excellent care of their gloves. The band will head off to the warm-up areas and the
pit equipment will head to the stadium. Water will be given out as we prepare to take
the field. During the warm-up process students are expected to focus and listen to
instructions the first time they are given. At the completion of our performance we will
head directly back to the bus and trailer. Booster Volunteers should meet us there
immediately. We will deplume and take up gloves. Then we will load up our
equipment. We may change out of uniform. Students will be expected to report to the
stadium in order to watch other bands perform. This is not free time. This is an
educational process. Students MUST actively watch other groups perform. This means
that all electronic devices will be turned off. Electronic devices that are confiscated will
be turned into the main office and will follow the same process as per Hough High
School policy. Students will be given a specific time to go get food and use the
restroom. Emergencies will be handled by the use of a booster escort. Students will
NOT hang out behind the stadium when they are expected to be watching bands in the
stadium. While in the stadium the band will sit as a block. During the awards
presentation the student leadership team will be in uniform on the field. The rest of the
band will stand at parade rest during the presentation. They are not to socialize but they
may cheer appropriately for other bands. Students who are not able to fulfill this
expectation will no longer travel or participate with the marching band. At the
conclusion of the awards ceremony all members will head towards and load the busses.
A restroom stop is suggested as we may have a long drive back. Students need to be
SILENT until we clear the competition site. Upon our return to Hough the same
expectations are employed as at the end of football games. Parade Performances
operate in a similar fashion with the exception that we typically don’t practice before we
leave.
Travel Expectations:
Transporting a large number of students is a monumental
task. Safety is our number one priority. Once loaded on the bus, students will be asked
to COUNT OFF. This is vital as it is a quick way to make sure everyone is on the bus.
The COUNT OFF begins at the front of the bus and works its way to the back. Students
must speak confidently and loud enough for the chaperone in the front of the bus to
hear. Students shall sit in the seat facing the front of the bus. When directed they may
talk quietly. They can use electronic devices with HEADPHONES! At night flash
photography should not occur as it is very distracting to the driver. Students bring their
devices at their own risk. When on campus of Hough or the other venue we must be
silent to help the driver get instructions and park. Before disembarking the bus we need
to make sure to close all the windows and pick up trash. A group of students will be
determined to clean the bus once the band has unloaded. This includes picking up trash
and sweeping the bus.
DUTIES OF A MARCHING BAND MEMBER
In an effort to create the best band possible, we need dedicated musicians to participate in our
band. To make the most of the opportunities the band offers, you must be a superior band student.
As a superior band student you will:
1. Be on time to all classes, practices and performances.
2. Arrive at all practices and performances prepared with correct equipment and a
positive attitude.
3. Make a real effort to learn and improve daily.
4. Maintain a strong academic standing in all other course work at school.
5. Be responsible for your actions. Accept the consequences of your choices.
6. Be personally clean. Be neat and dress appropriately.
7. Have a proper respect for those in authority.
8. Follow all classroom rules, school regulations, and travel instructions.
9. Be honest and fair with others concerning equipment, music and school life.
10. Cooperate with fellow band members and share with them the responsibilities and
privileges of the band program.
11. Contribute positively to your music education and that of others by the best use of
your talent.
12. Read and play music with care.
13. Improve your knowledge of music and develop good listening habits.
14. Above all, be dependable and trustworthy.
ATTENDANCE
In order to maintain the highest standards of excellence achieved by the Might Husky Marching
Band, certain attendance regulations have been set and are strictly enforced.
Attendance is expected and mandatory at all scheduled rehearsals, sectionals, and performances.
In order for an absence or tardy to be excused, the circumstances surrounding the incident must
be discussed with Mr. Carrington in person. Courtesy would dictate the necessity of reporting the
expected absence in advance of the rehearsal to be missed. Doctor's appointments, Drivers Ed,
labs and make-up work are not excusable. Plan accordingly and do the right thing.
Unexcused tardies or absences not only impact on the individual but also prohibit the band in
general from functioning properly at rehearsal. There is too much vested effort, time and money
involved in this activity for individuals to unaccountable for absences. Either an alternate will
automatically be inserted in a slot where an absent member is missing or their spot will be
removed from the drill.
It is Mr. Carrington’s position that advanced notice of potential conflicts can be agreeably worked
out to the benefit of both the member and the band. Information that is after the fact does not have
to be, and is most often not, considered in the same vain.
REQUIREMENTS OF MARCHERS
The Hough High School Marching Band will have a reputation of providing quality shows and
being a strong competitor with some of the best bands in the state of North Carolina. Each year we
will strive to win top honors in areas such as Music Performance, Marching Performance, General
Effect, Drum Major, Color Guard Performance and Percussion Performance. In order to build
this tradition of quality, the marchers are required to commit themselves to hard work and a good
attitude. In return they will have an extremely rewarding experience where learning can take place
and personal qualities such as teamwork, sportsman-like conduct, perseverance and personal
discipline are enhanced.
In order to participate in the marching band program the following commitment must be made:
1. Attend band camp
2. Attend all rehearsals during the weeks scheduled from August through December.
3. Attend all required football games, competitions, parades and other performances
4. Take quality care of band instruments, equipment and uniforms
5. Learn and memorize music according to schedules
6. Participate in fund-raisers and make prompt payment of Band Lab Fee and Assessments
7. Donate two cases of 16.9 oz. bottled water or a $10.00 fee will be assessed
8. Work together as a team
9. Be respectful to those in authority, band parents and volunteers
10. Follow the chain of command if problems arise
11. Always exhibit a good attitude
12. Be registered for band during the school day.
If in doubt about the requirements of a marching band participant, contact Mr. Carrington.
ALTERNATES
We recognize that there will always be extenuating circumstances that may prohibit a marching band
member's participation with the band such as illness, death in the family, etc. We try to plan for these
circumstances. Additionally, with a band of this size and caliber we make every effort to avoid the
occurrence and appearance of holes in the drill design. In order to accommodate both needs, we
employ alternates within our organization.
An alternate is defined as a band member who is not assigned a permanent position but who is
qualified to participate on a guaranteed basis as well as on call to fill an unexpected void.
Alternates are not second class citizens who do not perform. Alternates are depended upon to assist
the various sections during the daily rehearsals in the areas of double-checking charts, assisting
leaders with visual identification, assisting with equipment changes and performing in the stands.
We guarantee that an alternate will perform as needed positions open up. In my 24 years of
marching band experience I have discovered that most alternates are eventually incorporated into
the show by the end of the season. It is not uncommon to find an alternate being needed at the last
minute to fill a slot and perform as though they had prepared normally.
MARCHING BAND UNIFORM GUIDELINES
UNIFORM (u-ni-form), adj. 1. having the same form, appearance, manner, etc.: not varying among
themselves; conforming to a given standard; always alike. N 2. the official or distinctive clothes worn by the
member of a particular group.
The Hough High School Marching Band will have a tradition of precision and professionalism. As
a result it is important for you to remain in uniform at all times. Typically, the summer uniform
(black non-athletic shorts, Issued white polo shirt, white socks and white shoes) will be worn at
the first two or three football games, as decided by Mr. Carrington. The official competition
uniform will be worn at later football games, competitions, and parades. Jewelry, watches, ball
caps, etc. are not appropriate to be worn with the uniform. Long hair must be pinned up under the
shako. When wearing the official uniform, if the weather is unseasonably warm, you may remove
the band jacket with the permission of Mr. Carrington. You must have an official Band T-shirt on
under your jacket. When you remove your jacket, be sure to take care to keep it clean and neat.
While in uniform please eat only foods that will not stain the uniform. Remember that you will be
charged for unscheduled cleanings. After performances, you are responsible for storing your
uniform properly so it will not get wrinkled or dirty. You will be instructed concerning where it
may be stored. Your uniform will be cleaned two or three times during the year, depending on
number of performances and weather. If your uniform needs additional cleaning, you will be charged
for that cleaning. You will also be charged for any missing pieces.
The following are grooming policies for the Marching Band.
1. Hair -- There is to be NO hair on the collars of the uniform. Think of the bands you
have seen where the locks were flowing everywhere versus a trimmer approach for
which the neckline and headgear of the uniform were readily visible. Additionally, any
section that performs without headgear must understand for the sake of uniformity that
NO student will be allowed to march if they have an unusual hair color or unusual
haircut. Individuality is fine during school, but remember we are setting an image in a
uniformed fashion.
2. Facial hair -- Those of you with facial hair should trim it on performance days.
Remember that you are “on stage” and are a featured performer. More people see you
up close than you can imagine.
3. The uniform being issued to you will easily identify you as a Marching Husky. It must
be worn only at authorized appearances and must always be worn properly. Proper
care of the uniform is essential not only from the standpoint of taking care of high
school equipment, but also from the standpoint of pride. When the Marching Huskies
take the field, the visual impact is as great as the audible one. You should brush and air
the uniform before turning it into the Quarter Masters. When hanging the coat, place it
on the form shaped hanger and in an open space to allow it to hang neatly.
4. The uniform checked out to you should fit as perfectly as possible. If, however, it does
need some slight alteration, we will assure this is done. You are never to alter the
garment in any way.
5. The uniform must be worn properly at all times. This means that the entire basic
uniform will be worn or none of it will be worn. The jacket must be buttoned and not
allowed to dangle unzipped ever! The shako must also be worn appropriately. Any
deviation in the policy is considered disrespectful to the uniform and will drastically
limit the member’s participation in the marching band.
GRADING
The grade for marching band is determined primarily on the basis of attendance, music memorization
and regimentation during all facets of marching band operations. Random music memorization
assessments will be given throughout the season in order to guarantee that members uphold their end
of the musical investment. Students will also be graded on their ability to follow instructions and
perform appropriately. One unexcused absence lowers a member's grade one letter. Two unexcused
tardies constitute one unexcused absence. One unexcused tardy lowers a member’s grade by half a
letter. Parades will count as the Semester exam. More than two unexcused absences will result in the
student’s permanent removal from marching band.
BEHAVIOR EXPECTATIONS
All band functions are held to the same expectations as a regular school day class. All band members
will be held the highest expectations in regards to behavior. As representatives of Hough High School
we must exemplify the most positive characteristics of a Husky. Students will respect requests of the
professional leadership team and comply with reasonable requests of the student leadership team in an
expedient fashion. Since our booster organization is here to support the students, the students in
return will assist band boosters in every facet of the program without argument or delay. Any band
member who violates this expectation will be disciplined accordingly which may include school
related consequences and removal from the marching band.
ADMINISTRATIVE DIVISIONS
Each marching participant will be assigned to a specific administrative team. Each team will be
responsible for task or function needed for the marching band to operate. This includes equipment
crew, uniform operations, music library, field maintenance, as well as maintaining facilities. It may
be necessary to have students assigned to multiple crews if needed. The Quartermaster will assist in
the development of this program. We also will be assigning each new member a mentor in order to
foster a sense of comradery and to help the younger members as they become acclimated to the high
school marching band construct. There will also be an opportunity for students to assist other
participants who need help in specific academic areas so that all students will continue to do well in
school and marching band.
FACILITIES AND SCHOOL OWNED INSTRUMENTS
As a new high school we are very fortunate to have new instruments and a state of the art facility.
Students are expected to take excellent care of all equipment regardless of ownership. School Owned
Instruments will be issued to specific members and they are held accountable for any damage or repair
once issued to said student.
At Hough, we are lucky to have the state of the art Wenger Storage System. This allows our members
to have their own locker with a lock provided. You must use the lock issued to you by the band
department. Lockers are to be kept tidy. Food and beverage are not to be stored in our lockers. If a
locker is considered by Mr. Carrington to be in a “condemned” condition, the band member will lose
the privilege of storing their instrument in the storage room. Although every effort will be made to
secure the facility, it is imperative to note that Mr. Carrington and other school officials WILL NOT
be responsible for lost or stolen instruments and personal items. PLEASE RECORD YOU SERIAL
NUMBER WITH YOUR HOMEOWNERS AND RENTERS INSURANCE POLICIES. Many
music stores also provide maintenance agreements that include theft. See Mr. Carrington for details.
Much like the band room proper, the storage room is to be kept tidy and clean at ALL times.
Violators of this policy will automatically be nominated to clean the entire band suite (E630). Each
member will be issued a locker and a lock. You must use the assigned lock on the assigned locker.
This is for security purposes. You must also complete and sign the locker agreement form as well.
CHAIN OF COMMAND
INSTRUCTIONAL DIVISION
Mr. Carrington (Director of Bands) is in charge of the total band program at Hough High
School which includes all aspects of the marching band (e.g. music selection, drill writing, budget
administration, travel coordination, logistical requirements etc.)
Jamey LaFevers and Ashley Floyd (Directors of Percussion) reports to the Director of Bands
and has the duty of writing and incorporating the percussion book for our field show. This
includes the teaching of rudiments and fundamentals, instilling rigorous discipline, and
development of the percussion program.
Darin Morrow and George Adams (Director of Guard and Movement) report to the Director
of Bands and have the duty of writing and incorporating the guard book for our field show. This
includes teaching proper guard technique on multiple pieces of equipment, instilling rigorous
discipline, and development of the guard program.
COMMAND DIVISION
Drum Majors are the highest-ranking student leaders and assume complete command of the
organization in that respect. The Drum Majors ultimately report to the Director of Bands and work
with him in leading rehearsal and performances. The Drum Majors are also involved in the proper
teaching of marching fundamentals, providing warm up exercises, rehearsing and conducting both
the preparation and performance of the marching band, and are largely responsible for the promotion
of pride and spirit within the band.
Captains are the ultimate heads of their specific area such as Woodwind, Percussion, Brass and
Color Guard. Because of the nature of this job, these positions are limited to members who have
had a minimum of two season's experience.
ADMINISTRATIVE DIVISION
Quartermaster reports to the Drum Majors. He is in charge of Administrative Operations such
Uniform, Music, and Equipment Detail. Since this position involves much of what the band does
operationally, He is also involved in and navigates the proper use and treatment of the Uniform,
Music, and Equipment.
GENERAL
Veterans are the bandsman in the "trenches" who have participated at least one season. They
are instructed to help the Rookies to a higher level of performance. They are the ultimate
executors of getting the job done.
Rookies are the bandsman in the “trenches” who have no marching band experience. They
also are the ultimate executors of getting the job done.
REQUIREMENTS OF LEADERSHIP
When a student is selected or elected as a leader in the band it is an achievement of ability and
responsibility. Each leader provides a service either to the band or the professional staff. In the
same regard, expectations for leaders are slightly higher than for the other members. In return they
are given unique opportunities and privileges. True leaders are not bossy or argumentative, but
rather lead by example. They show interest in weaker members of the group and find ways to meet
others on mutual ground. They implement the objectives laid down by the Director of Bands and
the professional staff in a way that is effective and positive. In basic terms, true leaders are
excellent followers. If you have been selected as a leader you must comply with the following
guidelines:
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Support band director, professional staff and band program at all times
Be aware of and fulfill your specific job responsibilities
Attend as many Band Booster meetings as possible
Lead by example
ACTIVELY participate in all fundraisers
Fulfill all marcher requirements
BAND CAMP NECESSITIES
GOOD PAIR OF TENNIS SHOES WITH SOCKS (NO FLIP FLOPS OR SANDALS)
SUNSCREEN WITH A HIGH SPF FOR BOTH UVA AND UVB
HUGE WATER BOTTLE
HAT AND SUNGLASSES
MONEY FOR LUNCH AND DINNER
COMFORTABLE CLOTHES (THINK ON THE CONSERVATIVE SIDE)
PENCIL/PEN AND PAPER
HAND TOWEL
INSTRUMENT, MUSIC, AND SUPPLIES
LYRE AND FLIP FOLDER WITH EXTRA PAGES
TUNER
MEDICINE THAT MAY BE NEEDED/BUG STINGS ETC
POSTIVE ATTITUDE
THE BAND BOOSTER ORGANIZATION
The Hough High School Band program is supported by the Band Booster Organization, a group of
parents and students who are actively involved in the functioning of the Band. While the ultimate
authority is Mr. Carrington, the Band Booster Organization is available to assist the Director in
assuring the best possible music educational and developmental programs are offered to the
students of Hough High School. Should you have questions or comments concerning the Hough
High School Band program, please contact the director or any officer of the Band Booster
Organization.
The William A. Hough High School
Band Booster Club
P.O. Box 314
Cornelius, NC 28031
BAND LAB FEE AND
FUNDRAISING
The Bands of William A. Hough High School will be actively involved in various fundraisers
throughout the year. The funds raised go to help defray the costs of music, equipment,
transportation to competitions and contests and general upkeep of the school-owned
instruments. Without our fundraisers we would have a major deficit in our budget. The actual
cost per student is over $1000.00. Obviously fundraisers make up a major portion of our
revenues for the year.
Fruit Sale One of our largest fundraiser will be our fruit sale. Students will be expected to sell 10
units of fruit or pay the difference. The sale begins in mid-September and orders are turned in by
early November. The fruit will be delivered in December, just in time for the holidays.
Panthers Stadium Another outstanding fundraiser we offer to work at our Panthers Stadium
Concession Stand. It is a great way to work off your lab fee and meet other band parents.
Miscellaneous Fundraisers Each year various other fundraisers are introduced and promoted.
Take advantage of the fund raisers made available to you to help raise the necessary funds to
operate the band program. Each year the fundraising team will determine the best use of our time and
schedule fundraisers as needed.
MARCHING BAND LAB FEE SCHEDULE
You may pay the entire lab fee of $575.00
Or use the following payment schedule
6/1 $200
7/15 $200
9/1 $150
The $400.00 amount must be paid in full by August 1st in order to participate. The balance
will be due on September 1st. This fee includes the Wind Band Lab Fee. Fundraising
applies to forward balances.
FORMS THAT MUST BE COMPLETED
•
•
•
•
•
•
Marching Band Participation/Code of Conduct Contract
Universal Permission Slip
CMS Standard Photographic Release
Marching Band Audit Form (if auditing)
Athletic Participation Form
Notice and Release Form
MARCHING BAND DATES
Please review the schedule the below with your family calendar. Each band member
will be placed in a spot based on their availability and attendance. It may be necessary
to place a student as an alternate due to attendance concerns.
SUMMER REHEARSALS
HORNLINE (5-7PM): 6/6, 6/13, 6/20, 7/11, 7/18, 7/25
GUARD(9AM-5PM): 6/17-6/20, 7/15-18
PERCUSSION: TBA
BAND CAMP DATES
8/1-8/2 7am-4pm at Hough
8/4-8/9 Band Camp at Camp Lutherock at Sugar Mtn. NC
8/12-8/14 7am-8pm at Hough
9/14 8am-8pm
REGULAR REHEARSALS-TUESDAYS AND THURSDAYS 5pm-8pm
8/20, 8/22, 8/27, 8/29
9/3, 9/5, 9/10, 9/12, 9/17, 9/19, 9/24, 9/26
10/1, 10/3, 10/8, 10/10, 10/15, 10/17, 10/22, 10/24, 10/29, 10/31
PARADE REHEARSALS-TUESDAYS/THURSDAYS 2:30-4pm
11/5, 11/7, 11/12, 11/14, 11/19, 11/21
12/3, 12/5
FOOTBALL GAMES-MOST FRIDAYS
TBA
COMPETITIONS-SATURDAYS
9/28, 10/5, 10/12, 10/19, 10/26, 11/2
PARADES
Veterans Parade 11/9 or 11/16
North Mecklenburg Parade 12/7
Dear Parent:
In completing the form below, you and your student are indicating that the student will
join Marching Band as a volunteer participant for this school year. Although grades and
credit will not be received, volunteer members will be held accountable for the same
standards as those students receiving grades. Full participation is required and students
must uphold all policies and procedures outlined by the Charlotte-Mecklenburg Schools
and the school instrumental program. Failure to do so may result in discontinuation in
the program. If you have any questions regarding this letter, please contact me at
[email protected].
Sincerely,
Robert Carrington
Marching Band Director
Marching Band Volunteer Participant Form
I, _________________________________, request permission to join Marching Band
(Student’s Name, Please Print)
as a voluntary participant for this school year. I have read the above statement and
understand that grades and credit will not be awarded. I understand that full
participation is required and all policies and procedures for Charlotte-Mecklenburg
Schools and the school instrumental program must be followed. I also understand that
failure to comply with these policies may result in my discontinuation in the program.
________________________________________
Student’s Signature
_________________________
Date
________________________________________
_________________________
Parent’s Signature
Date
________________________________________
_________________________
Band Director’s Signature
Date
________________________________________
_________________________
Principal’s Signature
Date
C:
Permanent Record
Performing Arts Specialist
PHOTO AND VIDEO RELEASE FORM
I do hereby grant to Charlotte-Mecklenburg Schools the unlimited right to use and/or reproduce photographs*,
likenesses or the voice of my child in any legal manner and for the internal or external promotional and
informational activities of Charlotte-Mecklenburg Schools. I also agree to allow my child to be interviewed
and/or photographed* by representatives of the external news media and CMS-TV3 in relation to any and all
coverage of Charlotte-Mecklenburg Schools in which they are involved. I also agree to allow my child's work
and/or photograph* to be published on the Charlotte-Mecklenburg Schools Internet/Intranet Web Pages,
CMS publications or CMS-TV3. I further understand that by signing this release, I waive any and all present,
or future compensation rights to the use of the above stated material(s).
School Name: _______________________________________________________________________________________________
Student's Name: ________________________________________
Homeroom Teacher: _________________________________
Parent/Guardian Signature: ________________________________
Date: _____________________________________________
Parent/Guardian Name (Print): __________________________________________________________________________________
Parent/Guardian Address: ______________________________________________________________________________________
Signature of Witness: ____________________________________
Date: _____________________________________________
* Photograph in this Release Form is intended to only refer to photos of your child alone. Group photographs (2 or more
children), with no additional identifying information, are considered Directory Information. Please review the FERPA
information sheet provided in your packet.
THIS INFORMATION TO BE COMPLETED BY SCHOOL OFFICIALS ONLY.
Your Name:_____________________________________________
Date: _____________________________________________
Type of Material
Photograph
Slide
Videotape
Other (please specify:) _______________________________________________________________
Use of Material
(Please provide additional information such as name of news outlet, brochure, purpose of presentation, etc.)
News Outlet: ______________________________________________________________________
CMS Internet/Intranet Site(s):_________________________________________________________
Brochure:_________________________________________________________________________
CMS-TV3: _______________________________________________________________________
PowerPoint Presentation: _____________________________________________________________
Form # 6162.5 | 8/06
Please complete form and return to your student’s school.
page F-3
Hough Husky Marching Band Participation Contract and Code of Conduct
I am happy that you want to be a part of the award-winning Hough Husky
Marching Band. In order for the Marching Band to present the highest quality
performance possible, every band member counts on every other band member to
put forth their best effort. When even one band member fails to commit to the
Band, or fails to exhibit good conduct, the performance of the entire band is
affected. Therefore, as a requirement for membership in the Marching Band, you
and your parents/guardians must read and sign the following Participation Contact
and Code of Conduct.
-Robert Carrington, Director
Participation Contract
“There's a difference between interest and commitment. When you're interested in doing
something, you do it only when circumstance permit. When you're committed to
something, you accept no excuses, only results.” - Unknown
When you make the decision to become a part of the Hough Husky Marching Band, you
make a commitment to become part of a single unit dedicated to excellence. In addition,
the Hough Husky Marching Band makes a commitment to incorporating you as an equal
member of the group. You are committing your talents, your time, and your financial
support. The Band counts on you to fulfill the role you are given in the band and makes a
significant financial outlay on your behalf.
When you turn in your enrollment form to join the Hough Husky Marching Band, you
are immediately considered when music is being written, when marching drill is being
written, when buses for travel are being reserved, when shirts and other supplies are
being ordered, etc. Therefore, your initial enrollment deposit is a non-refundable
payment of $100. At least this amount or more is outlaid or committed by the band on
your behalf before the start of band camp.
Additional payments towards your marching band lab/participation fee must be made
according to the schedule that will be listed on the Band’s web site at
www.houghhsband.org. Payments MUST be made on time and all fees must be paid
prior to the start of band camp. If you decide prior to band camp that you do not want to
participate in the Marching Band, all fees paid (with the exception of the non-refundable
enrollment deposit of $100) will be refunded. Once you have attended band camp, no
fees can be refunded if you later decide that you do not want to participate in the
Marching Band. If you are removed from Marching Band due to violations of the Code
of Conduct, no fees will be refunded.
Be sure to consider the following when making the commitment to join the Hough Husky
Marching Band:
•
All students are required to attend ALL practices, sectionals, games, competitions,
events and activities as listed on the Calendar. Absences from rehearsals have a
significant effect on the band’s ability to move ahead. Since we must perform as
a complete group, it is therefore imperative that we rehearse as one.
•
All students are required to be on time for all practices, sectionals, games,
competitions, events and activities listed on the Calendar. On time means be in
your spot with your instrument or equipment ready to perform. To be on time,
you must arrive at school (or other meeting place) at least 15 minutes before call
time. Remember, early is on time, and on time is late.
•
All students are required to make sure other commitments will not conflict with
the Marching Band calendar. This means all vacations, driver’s education,
doctor’s appointments, sports, clubs, etc. must be scheduled at times that do not
conflict with the Marching Band calendar. These types of events will not be an
excuse to be absent, late, or leave early from any Band practice or event.
•
Students must make a commitment to practice their music every day and
memorize it as soon as possible. Only with continued practice will student
performance improve. It is expected that all students will come in to the
marching band program with different levels of expertise; however, every student
should continually strive to improve and never feel that they’ve reached a level
where they do not need to improve. Students who have not mastered and
memorized their music by the time performances begin may be asked to sit on the
sidelines and let an Alternate fill their position until they have sufficiently
practiced and learned their music.
•
All students are required to participate in all Marching Band fundraisers.
Fundraising efforts are necessary to help keep student participation fees as low as
possible. Fundraisers are also necessary for the continued growth of the band
programs and provide a bonding experience among students.
•
All parents/guardians are expected to assist with the Marching Band as they are
able. The success of the band depends on the help provided by the adults
committed to their students. Adults are needed to chaperone at football games,
competitions, and other performances. Adults are needed to help with uniforms,
equipment, dinners, etc. Adults are also needed for several fundraisers such as the
Panther’s concession booth, citrus fruit sale, competitions hosted by our Band,
etc.
Code of Conduct
“Music is a discipline, and a mistress of order and good manners; she makes the people
milder and gentler, more moral and more reasonable.” -Martin Luther
The success of the Marching Band is dependent upon the dedication, attendance, and
appropriate behavior of all members of the group. Absences and tardiness from rehearsals
have a significant effect on the band’s ability to move ahead, as do negative or
inappropriate behaviors. When you wear the uniform of the Hough Husky Marching
Band, you are identified as a representative of the band, of the school and of the
community. Even when not performing, your role as an ambassador continues. As such,
all members of the Hough Husky Marching Band will be held to high behavior standards.
The minimum expectations of appropriate behavior can be found in the Hough Husky
Marching Band handbook and the Charlotte Mecklenburg Schools Student Rights,
Responsibilities and Character Development handbook.
There will be immediate consequences for not following the Code of Conduct, and
continued offenses can result in the student being suspended from the next marching
performance, being referred to the school for appropriate school penalties, and dismissal
from the Marching Band. Some important guidelines to remember:
•
Insubordination will not be tolerated. Marching band members are expected to
follow the direction of directors, band staff, and any students in leadership
positions (drum major, section leader, etc.).
•
Marching band members are expected to use appropriate language at all times.
Use of swear words or inappropriate discussions are unacceptable while
representing the band.
•
All students are required to attend ALL practices, sectionals, games, competitions,
events and activities. Any absence, late arrival, or early dismissal must be
approved by the band director at least two weeks in advance. The only exception
to this policy is illness, death in the family, or other family emergency. The band
director has final discretion as to whether a particular family emergency is a
justifiable reason for absence, late arrival, or early dismissal. Unexcused tardies
or absences not only impact on the individual but also prohibit the band in general
from functioning properly at rehearsal. There is too much vested effort, time and
money involved in this activity for individuals to be unaccountable for absences.
Either an alternate will automatically be inserted in a slot where an absent
member is missing or their spot will be removed from the drill
•
Eating and drinking are permitted only during designated times while in uniform.
•
Use or possession of tobacco products, alcoholic beverages and/or narcotics is
strictly prohibited. Students violating this policy will be reported to the proper
authorities where they will face legal consequences in addition to school
penalties.
•
Body language and gestures must be appropriate at all times. Students must
refrain from inappropriate gestures, excessive displays of public affection, etc.
while representing the band.
•
Bullying, harassment or fighting of any sort is unacceptable.
•
Students must be in eye-shot and ear-shot of a supervising adult at all times. In
the event a student needs to separate from the main band (bathroom, medical,
etc.), they must be accompanied by an adult.
This list is not comprehensive and represents only the key items. In addition to the
consequences listed above, students in violation of the code of conduct will be subject to
appropriate school penalties (as listed in the student handbook). Depending on the
severity and/or repetition of violations, the director reserves the right to remove any
student from the band. Any offense that would result in out of school suspension (OSS),
committed while attending a band event or practice, will be grounds for immediate
dismissal from the band.
A student that has been removed from the band for any reason will not receive credit for
their participation during that season. At the discretion of the director, the student may
not be permitted to join other extracurricular music ensembles (pep band, jazz band, etc.).
The student may apply for readmission at the beginning of the next marching season.
Readmission is at the discretion of the band director.
STUDENT AGREEMENT
I have read and agree to follow the rules and regulations set forth in this Participation Contract,
this Code of Conduct, the Hough Husky Marching Band Handbook, and the Charlotte
Mecklenburg Schools Student Rights, Responsibilities and Character Development handbook. I
have also read the calendar, and I am aware of the dates to which I am committing. I realize the
importance that my attendance plays in the success of the marching band, and I agree to abide by
the guidelines stated in this policy. I understand that failure to follow the Code of Conduct and
the rules in the handbooks will subject me to penalties and consequences. I further understand
that if I am unable to comply with these rules and the associated penalties, I will be dismissed
from the Hough Husky Marching Band with no refund of fees paid.
I agree that I have read and understand what is expected of me with regard to the maintenance
and wearing of my band uniform. I realize that I will be expected to replace, at my own expense,
any part of the uniform that is lost or damaged while it is issued to me. I also agree to pay for any
unscheduled cleanings that may be required for my uniform, due to misuse or excessive soil.
If I am a member of the student leadership team I agree that I will be an example to those under
my direction and will perform the responsibilities of a leader as is described in Marching Band
Handbook. Please fill out the rest in neat handwriting:
Student Signature: ______________________________________ Date: _________________
Student’s Printed Name: ________________________________________________________
Marching Instrument: __________________________________________________________
Shirt Size (Circle)
Small
Medium
Large
XL
XXL
Student Email Address: ________________________________________________________
Schedule Conflicts and Dates: __________________________________________________
******************************************************************************
PARENT/GUARDIAN AGREEMENT
I/We, the parent(s)/guardian(s) of _______________________________, have read the Hough
Husky Marching Band Participation Contract, the Code of Conduct, the Hough Husky Marching
Band Handbook, and the Charlotte Mecklenburg Schools Student Rights, Responsibilities and
Character Development handbook. I/We have also read the calendar, and am/are aware of the
dates to which my/our student is committing. I/We agree to help our student to fulfill his/her
obligation. I understand that there will be consequences for not following the Code of Conduct
and the rules as listed in the handbooks and the consequences can lead to the student’s dismissal
from the band with no refund of fees paid. This form needs to be signed by any parent or
guardian of the student who will be caring for the student during the marching band season.
Signature: _____________________________________ Date: ________________
Signature: _____________________________________ Date: ________________
CHARLOTTE-MECKLENBURG SCHOOLS
CLASS TRIP STUDENT PERMISSION FORM
Date:
May 1, 2013
Dear Parents:
Class trips have been approved to all regularly scheduled Hough High Marching
Band functions for the 2013-2014 School Year
Purpose: To represent Hough High School at selected marching band activities
such as clinics, festivals, competitions, football games, and requested
performances.
The signature of a parent/guardian is required in order to allow your child to
participate in these off-campus trips. Please sign the bottom portion of this form
and return the entire form to the teacher.
Sincerely,
Robert W. Carrington
Director of Bands
William A. Hough High School
Mode of travel: [X] School/Activity Bus
Cost of trip (if any):
[ ] Car(s)
[ X] Other : Charter Bus
$TBD
Time of departure from school: TBA
Time of return to school: TBA
I have read the field trip description.
I give permission
I do not give permission
for
to go on this trip sponsored by the
Student’s full name
Charlotte-Mecklenburg schools. Cash or check enclosed, if applicable.
Date
Parent/Guardian
Charlotte-Mecklenburg Schools
High School Student-Athlete Pre-Participation Form
* Please take the time, read through the questions, and answer to the best of your knowledge.*
PERSONAL & EMERGENCY CONTACT INFORMATION
Name (First, MI, Last): ________________________________________________________ CMS Student ID # __________________
Gender:
M
Age: ______________ Home Phone: __________________________
F Date of Birth: ___________________
Parent(s) / Legal Guardian(s) Residing With: _________________________ Who has legal custody? ____________________________
Father’s Name: ______________________________________________ Alternate Phone (Work or Cellular): ______________________
Mother’s Name: ______________________________________________ Alternate Phone (Work or Cellular): ______________________
Street Address: ___________________________________________________________ Apartment / Unit # ______________________
City: ______________________________________________________ State: ________________ Zip Code: ____________________
Family Physician/Pediatrician: ____________________________________________________ Phone: ___________________________
Permission to Transport:
Preferred Hospital:
Yes
No
SPORT (*check all sports you are considering to participate in*)
FALL
WINTER
SPRING
Football!
Men Basketball!
Baseball!
Men Cross-Country!
Women Basketball!
Softball!
Men Soccer!
Wrestling!
Men Track!
Cheerleading!
Cheerleading!
Women Track!
Women Tennis!
Men Swimming / Diving!
Women Soccer!
Women Cross-Country!
Women Swimming / Diving!
Men Golf!
Women Volleyball!
Men’s Indoor Track
Men Tennis!
Women Golf!
Women’s Indoor Track
Men Lacrosse!
!
!
Women Lacrosse!
INSURANCE
School Board Policy (#5143) requires that all students who participate in athletics be adequately covered by medical or accident insurance.
We acknowledge that it is the signed responsibility to notify CMS of any changes that occur to the personal insurance policy below and
affect the procedures in which the above-named individual may receive treatment; this includes loss of coverage. We certify that we have
purchased and will maintain in full force and effect during student-athlete’s participation in athletics the following insurance policy:
Check One:
" School Accident Insurance
" Personal Insurance Company
__
Name of Insurance Company
Policy Number
Insurance Phone for Authorization
Policy Holder
Group Number
__
RELEASE
In consideration of CMS allowing the above-named individual to participate in athletics, we agree to release and hold CMS, its athletic
coaches, and other employees free, harmless and indemnified from and against any and all claims, suits, or causes of action arising from
or out of injury that the student-athlete may suffer from participation in athletics other than an injury from gross or willful negligence.
ASSUMPTION OF RISK
We acknowledge and understand that there is a risk of injury involved in athletic participation. We understand that the student-athlete will
be under the supervision and the instructions of the coach in order to reduce the risk of injury to the student and other athletes. However,
we acknowledge and understand that neither the coach nor CMS can eliminate the risk of injury in sports. Injuries may and do occur.
Sports injuries can be severe and in some cases may result in permanent disability or even death. We freely, knowingly, and willfully
accept and assume the risk of injury that might occur from participation in athletics.
HIPAA / FERPA RELEASE
The above named student-athlete has opted his/her rights under the US Department of Health and Human Resources guidelines. By
signing this release, the student-athlete allows sharing of medical information between the Sports Medicine Staff (team physicians and
medical staff, athletic trainers, and student assistants), the CMS Athletics Staff (Athletic Director and Coaches), CMS Administration and
his/her medical provider(s). In the event of an emergency situation, information may be shared with emergency medical personnel. Every
reasonable effort will be made to protect this information. It is understood that once this medical information is disclosed, it is no longer
protected under the HIPAA/FERPA guidelines.
PARENT / GUARDIAN SIGNATURE
Student-Athlete Signature:
Date:
Parent/Guardian Signature:
Date:
Approved: March 2010
IMPORTANT: Student Accident Insurance for Athletics NOTICE and RELEASE THIS NOTICE AND RELEASE MUST BE SIGNED AND RETURNED BEFORE YOUR SON/DAUGHTER CAN PARTICIPATE IN THIS PROGRAM. TO: Parents of Students Interested in Participating in Athletics/MB SUBJECT: Student Accident Insurance for Athletics SPORT(S): ____________________________________________________ Please read this Notice & Release carefully and make sure that you understand its Provisions BEFORE deciding whether to permit your son or daughter to participate in this program. 1. Board of Education Policy No. 5143 requires that the Student Accident Insurance offered by the school system will be REQUIRED for all students participating in middle and senior high school athletics unless an insurance waiver form is signed by the parent indicating adequate personal insurance and releasing the Board of Education and its employees from responsibility for any claim due to injuries received while participating in a school sponsored program. 2. There are limitations in the Student Accident Insurance coverage. IT WILL NOT ALWAYS PAY ALL OF THE CHARGES INCURRED FOR EVERY ACCIDENT. For a summary of the coverage and benefits provided by the Student Accident Insurance, please read the current Student Accident Insurance Brochure that was furnished to each student at the beginning of the school year. If you did not receive the brochure or if you have questions about the insurance coverage provided under the policy, contact the Director at the school where your son/daughter is enrolled. 3. To be eligible for practice or participation in any school athletic program, each participant must receive an ANNUAL MEDICAL EXAMINATION and return a physical examination form each calendar year (once every 365 days) signed by a physician licensed to practice medicine. 4. Neither the Board of Education nor any of its employees assumes any responsibility for claims resulting from injury to your son/daughter while he or she is participating in the school program. This means that you will have to pay for any medical expenses not covered by the Student Accident Insurance, any personal insurance coverage that you might have and/or any other applicable insurance. 5. I, _____________________________________, (print name) hereby state that I have read and understand the provisions of this Notice and Release as well as the Student Accident Insurance Brochure. I further state that prior to signing this document I have had an opportunity to ask questions and that my questions have been answered to my satisfaction. I acknowledge that neither the Board of Education nor any of its employees assumes any responsibility for claims resulting from injury to my son/daughter due to his or her participation in this program. I HEREBY WAIVE, RELEASE, AND DISCHARGE the Charlotte-­‐
Mecklenburg Board of Education and its employees from any responsibility for claims resulting from injuries to my son/daughter due to his or her participation in this athletic program. I hereby certify that my son/daughter has received a MEDICAL EXAMINATION and has returned a physical examination form in compliance with the policy set forth in paragraph 3 of this Notice and Release. I certify that I consent to have my son/daughter participate in the school activity as identified on this Notice and Release. I make the following representation and selection (check one, sign and return promptly): __________ I have adequate personal insurance that will cover injuries that might be sustained by my son/daughter as a result of his/her participation in the program. I understand that in the event my son/daughter sustains any injuries as a result of his/her participation in the school activity, I am responsible for payment of medical expenses or other items not covered by any personal insurance. __________ My son/daughter has enrolled in the Student Accident Insurance Program on the following date: ________________. I understand that in the event my son/daughter sustains any injuries as a result of his/her participation in the school program, I am responsible for payment of any medical expenses or other items not covered by the Student Accident Insurance. SIGNED (PARENT OR LEGAL GUARDIAN): ______________________________________ DATE OF SIGNATURE: _____________________________________________________ ADDRESS: _______________________________________________________________ STUDENT’S FULL NAME: ___________________________________________________ SCHOOL: ________________________________________________________________ STUDENT’S SOCIAL SECURITY NUMBER: _______________________________________ Form 5120.6
Page 1
MEDICATION AUTHORIZATION FOR CMS STUDENTS
School Name___________________________________Telephone_____________________Fax_______________________
To the parent or guardian of ______________________________________________Birth Date______________________
In order to help protect your child's health, your consent and written authorization from a licensed healthcare provider are
required when it is necessary for your child to receive either prescription or non-prescription medicines in the CharlotteMecklenburg Schools. No medications will be given to your child at school until this authorization has been received. A
separate form is required for each medicine. New authorization forms are required every year at the beginning of school,
whenever the dose or directions change, or when a new medicine is prescribed. It is your responsibility to provide all
medicines to be given at school. Each medicine must be in an appropriately labeled original container from the pharmacy or
healthcare provider's office. Most pharmacies will provide an extra container for school use upon request. Administration of
non-prescription medicines at school is discouraged.
PARENT OR GUARDIAN'S PERMISSION: I give permission for my child to receive the medicine described below
during school hours. I understand that it is my responsibility to purchase and supply this medicine. On behalf of my child I
absolve the Charlotte-Mecklenburg Board of Education and their agents and employees from any and all liability whatsoever
that may result from my child taking this medicine at school.
_______________________________________________ _____________________________________________________
Signature of parent or guardian
Date
Contact numbers (pager or mobile, work, home telephone #s)
FOR LICENSED HEALTHCARE PROVIDER USE ONLY: please write legibly using lay terms
Medication prescribed:________________________________________Strength/Dose________________________________
Specific Directions [include exact amount to give, at what time and/or how often, relationship to meals, specific indications, e.g. if prn (as
needed)]:
Purpose of Medication:____________________________________________________________________________________________
Relationship to meals, if applicable _________________________________________________________________________
How often and at what time (hour):_________________________________________________________________________
Specify side effects or adverse reactions:
___________________________________________________________________________________
Other instructions (including emergency situations)____________________________________________________________
______________________________________________________________________________________________________
Please check all appropriate items. If either of the first two items is checked, page 2 of this form must be completed.
 Please allow this student to self-administer this medication while at school during school hours (must complete page 2
of this form).
 This student should carry the medication with him/her at all times during the school day, while at school-sponsored
events, or while in transit to or from school or school-sponsored activities (must complete page 2 of this form).
 This medication is to be used for emergencies only.
It is necessary for this student to receive this medication during school hours in order to maintain or improve health and to
benefit from school attendance. Please notify the principal and/or school nurse and parents/guardians if there are any
problems.
_________________________________________________ _________________________ _________________________
Signature of Healthcare Provider
Date
Telephone
Fax
______________________________________________ ______________________________________________________
Please print Provider's last name
Practice name or address
FOR SCHOOL USE ONLY:
Date Received/By: ___________________________________________School Nurse Review:_________________________
Form 5120.6
Page 2
AUTHORIZATION FOR SELF-MEDICATION BY CMS STUDENTS
Student's Name__________________________________________ Birth Date_____________________
Medication___________________________________for ______________________________________
Eligibility: In accordance with CMS Policy JLCD, Administering Medications to Students, and its
accompanying regulation, JLCD-R, only students who meet the following descriptions may possess and
self-administer medications: (1) Students with special medical needs such as asthma and/or severe
allergies or who are subject to anaphylactic reactions and may require emergency medications (i.e.,
asthma inhaler or epinephrine auto-injector [“Epi-pen”]); and (2) Students who require frequent
administrations of non-prescription medications or prescription medications that are not controlled
substances.
Healthcare Provider: The student named above has (1) asthma or an allergy that could result in an
anaphylactic reaction and may require emergence medications; or (2) a condition that requires frequent
administration of a prescription or non-prescription medication. The medication is not a controlled
substance. This student is capable of, has been instructed on the procedures for, and has demonstrated the
skill to self-administer this medication as directed on page 1 of this form. Please allow him/her to selfadminister the medication during school hours and as otherwise indicated on page 1 of this form.
This student will not require adult supervision while taking this medication.
Physician signature/date_____________________________________________________
Parent/Guardian: I give consent to the Charlotte-Mecklenburg Schools to allow my child to selfadminister this medicine at school. I understand that my child and I assume responsibility for the proper
use and safekeeping of this medicine. If the medication that is prescribed for my child is for the treatment
of asthma or anaphylactic reactions, I agree to provide a supplementary supply of the medication that will
be kept by the school in a location to which my child has immediate access. I absolve the CharlotteMecklenburg Board of Education and their agents and employees from any and all liability whatsoever
that may result from my child possessing or taking this medicine at school. I further consent for the
information about my child included on pages 1 and 2 of this form to be shared with appropriate school
staff as necessary for the safety of my child.
Parent signature/date _______________________________________________________
Student: I am capable of taking this medicine as recommended and accept this responsibility. I will
keep it secure at all times and will not share it with others. I understand that I will be subject to discipline
under the Student Code of Conduct if I abuse the privilege of being allowed to self-medicate while at
school or school-sponsored activities. Unless the medication is prescribed for the treatment of asthma or
anaphylactic reactions, I understand that I will lose the privilege of self-administering my medication if I
do not follow these rules.
Student signature/date ______________________________________________________
School Nurse: I have reviewed this request and acknowledge that this student has demonstrated the skill
level to self-administer this medication. I have informed this student that he or she must tell an
appropriate staff member whenever he or she has used the medication at school.
Nurse signature/date ________________________________________________________
Updated 6/05
Med 1