MCC Athletics Drug Testing Consent Form


 

Email *
As a condition of being allowed the privilege of participating in intercollegiate athletics at Manhattan Christian College, I hereby agree to submit one or more samples of my urine for screening purposes set forth in the MCC Student-Athlete Handbook.
*
I understand and agree that I may be required to submit samples based on both reasonable suspicion and on a random basis.
*
I also understand and agree that I may be disciplined for any violation of the rules set out in the handbook, including (for example, and not by way of limitations) failing or refusing to submit a sample when required.
*
I hereby release Manhattan Christian College, the MCC Athletic Department, and any testing laboratory selected by the college,  all employees, agents and officers of any of these entities, including specifically (but without limitations) the Board of Trustees of Manhattan Christian College, from any and all liability of whatsoever kind, arising from any request made of me pursuant to the handbook, to furnish samples(s), the testing of said samples(s), and any decisions made concerning my athletic or academic status that may be based upon the results of such test(s).
*
I agree that, if I am taking any substance that has been “legally prescribed” for me by a medical practitioner, I will be required to provide written documentation demonstrating proof of that prescription. The documentation will be kept in my permanent athletic department medical file. If I test positive for a banned substance and fail to produce proper documentation that it has been prescribed for me, I may be disciplined under the Manhattan Christian College Student Handbook and Student Athlete Handbook even if the prescription was legally prescribed for me.
*
I understand that taking prescription medicine not prescribed specifically for me may be punished as a felony crime in the State of Kansas.
*
Student Name


*
Date *
MM
/
DD
/
YYYY
Signature 

Type full name - represents digital signature
*
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Manhattan Christian College. Report Abuse