Transcript Southeast Region Pop Warner

Southeast Region
Pop Warner
Team Book Order
Updated 2014
Team Book Order
for Book Check
Correct book order:
Start with this documentation
• Certified National Roster
• Book Certification Error Form
• Rostered copies of Mandatory Play Roster
(MPR) from League one
• Football – USA Heads Up Certificate, Southeast
Region Coaches Certificate and Southeast
Region Team Parent Certificate.
• Cheer/Dance – YCADA Coaches Certificate,
Southeast Region Coaches Certificate and
current ASEP
• First Aid/CPR card(copy)
• Emergency Action Plan
• Participants information in the following order:
• Football – O/L-jersey number then regular
weight in jersey number
• Cheer/Dance –
•
•
•
•
Mascots
Coach Trainees
Student Demonstrators
Alpha order for all other participants
.
Book Certification Error Form
This form documents items that are incorrect.
Team Book Order
continued
Certification documentation must be placed in the team
book in the following order for EACH participant:
• Sleeve #1 FRONT:
•
SE Region PW Official ID Card
• Sleeve #1 BACK:
•
Birth certificate (do not attach to ID Card)
• Sleeve #2 FRONT:
• 2nd page of Physical form – Doctor’s Signature page
• Sleeve #2 BACK:
• 1st page of Physical form
• Sleeve #3 FRONT:
• 2nd page of Participant/Parental Consent Form –
Signature page
• Sleeve #3 BACK:
• 1st page of Participant/Parental Consent Form
• Sleeve #4 FRONT:
•
Scholastic info.- GPA Spreadsheet & Report Card
• Sleeve #4 BACK:
•
Waivers, Special information
• Sleeve #5 FRONT:
•
Team Parent Certificates
Sleeve #1 Front -Official ID card
The front of this sleeve must be cut out on the bottom section to allow the
card to be stamped without removing the sheet each week.
The Association fills out the top two sections with the exception of the ‘Certified
Weight & Date’ (for football) and ‘Cheer Certified Insert Date’. The League Official
will be responsible for completing these fields when signing the card to certify the
participant.
The League adds the ‘certified weight & date’ for football, for Cheer/Dance the
League adds the ‘certified date’. The card is then signed by League Official.
League
Stamp in clear area
Sleeve #1 Back - Birth Certificate
(an original certificate or a certified copy)
The League Official should stamp in a clear area on the copy which verifies
they have compared the original certified document to the copy.
If the birth certificate is in a foreign language, a notarized document
translating the vital information into English should be attached. (Sample
translation form on next slide).
Tip: When comparing the birth certificate to the ID card and the roster, make
sure to check the spelling of the child's name and verify the date of birth was
used instead of the date filed as this is a common mistake.
Foreign Language Birth Certificate
Sample Translation Form
All this
area
needs to
be filled
out also
League
Stamp Here
Sleeve #2 Front- Pop Warner Physical Form- 2nd page Doctors
Signature Page
No Whiteout
The League Official should verify the following: the participants name, the physical section is
filled out, the Dr. has signed or stamped the form, the Date of Signature is in the current year,
the medical profession is on the list of approved degrees (see attached list) and if the Dr. has
indicated that follow up is required that there is documentation this has been done. **NOTE:
the following professions are not permitted to perform physicals - RN, Medical Assistants
(MA), LPN, CAN, Athletic Trainers, Certified or Registered Chiropractor Assistants,
Acupuncturists.
Medical Doctor (MD)
Doctor of Osteopathy (DO)
Can They
Complete
and sign off Reason
on the
Physical
Yes
Able to diagnose
Yes
Able to diagnose
Physician Assistants
Yes
Title
Authority
Fla. Stat. 458.305
Fla. Stat. 459.003
Is licensed to perform medical services
and diagnose.
Fla. Stat. 458.347(2)(e); F.A.C.
64B8-30.001 and 64B8-30.012
Medical Assistant
No
Advanced Registered Nurse Practitioner
(ARNP): including certified registered
Yes
nurse anesthetists, certified nurse
midwives, and nurse practitioners
Not able to perform diagnoses
458.3485
Given explicit authority to diagnose.
Fla. Stat. 464.003(3) and (20);
Fla. Stat. 464.012(3); F.A.C.
64B9-4.001 and 64B9-4.009
Clinical Nurse Specialist (CNS)
Given explicit authority to diagnose.
Fla. Stat. 464.003(6), (7) and
(20); F.A.C. 64b9-15.002
Yes
Registered Nurse (RN)
No
Licensed Practical Nurse (LPN)
No
Certified Nursing Assistant (CNA)
No
Athletic Trainer
No
Chiropractic Physician (Chiropractor)
Yes
Certified Chiropractic Physician's
assistant
No
Practices professional nursing, the same
as a CNS and ARNPs. ARNPs are just
certified in advanced or specialized
nursing practices. Can perform
assessments and nursing diagnosis. RN's Fla. Stat. 464.003(20) and (22);
are licensed to do what is referred to as a F.A.C. 64B9-15.001
nursing diagnosis. Physicals fall within the
scope of what is referred to as a medical
diagnosis, however, and RNs are not
licenses to perform them.
Fla. Stat. 464.003(16) and (19);
no authority to perform an diagnosis .
464.003(5); F.A.C. 64B915.001
Nursing Diagnosis is not listed as a
Fla. Stat. 464.201(5); F.A.C.
function and must perform job under the
64B9-15.002
supervision of an RN or LPN
Can treat athletic injuries but no authority
Fla. Stat. 468.701 and 468.713;
to do complete physical examination and
64B33-4.001
make a diagnosis.
Diagnosing medical conditions is not listed
under the definition of the practice of
chiropractic medicine. However, in
section (e) it states that they can analyze 460.403(9)(a) and (9)(e).
and diagnose the physical conditions of
the human body to determine abnormal
functions and their causes.
May perform physical exams but also
states they function in a dependent
relationship with a supervising physician.
Also states that they cannot render
diagnostic results or interpretations or
460.4165; F.A.C. 64B2render treatment advice "unless properly
18.001(5)
certified." My reading is the Physician
must sign off on the physical because we
are asking that they certify there are no
medical impediments to the child
Sleeve #2 Back- Pop Warner Physical Form1st Page
The League Official should verify that the parent or legal
guardian has signed and dated the form as well as fully
completing the medical history information.
League
Stamp Here
Sleeve #3 Front- Participant/Parental Consent
Form- signature page
The League Official is verifying the following on this form:
• The person signing the form is the parent or legal
guardian and the form is dated
• The participants name is on the form
• The participant has signed the form (regardless of how
young)
Sleeve #3 Back- Participant/Parental
Consent Form
This form should be filled out completely above the
'Official Use Only' section, including the email and
emergency contact information.
Sleeve #4 Front- GPA Spreadsheet with full
report card behind the spreadsheet
The names on the GPA Spreadsheet and the report card
must match. The report card must include all 4 – 9 week
periods or semesters from the previous year.
This sheet can ONLY BE STAMPED by the League
Scholastic Coordinator. See above for correct format of
stamp.
Sleeve # 4 Back Waivers/Special information.
All Legal paperwork including:
Examples:
Waivers-(1st)
Name Changes
Guardianship
Adoption papers