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JCDAC-1 03-08-05 DRUG AND ALCOHOL POSSESSION AND USE The Board of

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JCDAC-1 03-08-05 DRUG AND ALCOHOL POSSESSION AND USE The Board of Powered By Docstoc
					                                                          JCDAC-1
                                                         03-08-05
DRUG AND ALCOHOL POSSESSION AND USE

The Board of Trustees, in recognizing that the use of drugs,
alcohol, and other chemicals among young people has become a
major problem in our country and because the use and availability
of these substances on school campuses interferes with the
educational process and endangers the health of students, has
adopted this policy.    It is designed to act as a deterrent,
protection, and punishment for all students.

Awareness and Education Concerning Improper use of Alcohol and
Drugs:

The administration shall, in the elementary and secondary
schools, include a curriculum that will assure that students are
made aware of the physical and psychological dangers incurred
through   the  improper  use   of  alcohol   and  drugs.     The
administration and staff will cooperate with other community
agencies and organizations in programs of alcohol and drug
prevention.

Cooperation with Governmental Agencies:

The administration and staff shall cooperate with the local,
state, and federal agencies in the detection, prevention, and
prosecution of any and all possible alcohol and drug violations.
All cases of policy violations of drugs shall be promptly
reported to the appropriate law enforcement agency.

When and Where Policy is Applicable:

This policy applies to any student who is on school property, who
is in attendance at school or at a school-sponsored activity, who
is wearing a school-owned uniform/costume on or off school
property, or whose conduct at any time or in any place interferes
with or obstructs the missions or operations of the school
district or the safety or welfare of students or employees.
School sponsored activity includes, but shall not be limited to,
practice, rehearsal, participant, or spectator both on and off
school property both within and outside of the school district.

Prohibited Activities:
It shall be against school policy for any student:

1.   To sell, supply or give, or attempt to sell or give, to any
     person any of the substances listed or described in this
     policy or what a student represents or believes to be any of
     the substances listed or described in this policy.

2.   To possess, procure, or purchase, or attempt to possess,
     procure, or purchase, to be under the influence of (legal
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DRUG AND ALCOHOL POSSESSION AND USE

     intoxication not required), or to use or consume or attempt
     to use or consume, the substances listed or described in this
     policy or what is represented by or to the student to be any
     of the substances listed in this policy or what the student
     believes is any of the substances listed or described in this
     policy.

Prohibited Substances and Penalties:

Any student in grades 5-12 engaging in the prohibited activities
listed above with respect to the following prohibited substances
shall be subject to immediate suspension of ten (10) days and
shall further be subject to provisions of School Board Policy
JDE-1,2&3 (Student Expulsion, Long and Short Term Suspension).
Students in grades K-4 will be suspended for not less than one
day.    The parent, guardian or custodian that is court or
Department of Human Services appointed will be required to bring
the student to school for a conference before the student will be
readmitted. The student, upon readmission, will be referred to
the counselor and/or possibly an outside agency for assistance.
If the problem persists, the student's actions will be considered
under the policy for grades 5-12.

1.   Alcohol or any alcoholic beverage.

2.   Any controlled substance (drug, substance, or immediate
     precursor described, but not limited to, Schedules I through
     V of Sections 41-29-113 through 41-29-121 of the Mississippi
     Code), including, but not limited to, marijuana, any narcotic
     drug, any hallucinogen, any stimulant, or any depressant or
     any "look-alike":   or counterfeit substance represented to
     be, believed to be, any of the substances listed or described
     in this policy.
3.   Any abusable glue or aerosol paint or any other chemical
     substance, including, but not limited to, lighter fluid and
     duplicating fluid, for inhalation.

4.   Any prescription or non-prescription drug, medicine, vitamin,
     or other chemical including, but not limited to, aspirin,
     other pain relievers, stimulants, diet pills, multiple or
     other type vitamins, pep pills, "no-doze" pills, cough
     medicines and syrups, cold medicines, laxatives, stomach or
     digestive remedies, depressants and sleeping pills not taken
     in accordance with the authorized use procedure (all
     medication must be administered in the school office and only
     when written authorization/instructions from the parent are
     on file).

LEGAL REF.: §41-29-113 through §41-29-121, Mississippi Code
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                              DRUG AND ALCOHOL POSSESSION AND USE

Drug Testing

The McComb School District recognizes students as present and
future assets to our sports, academic and leadership education
process. Students, as role models to other students, are a key
to our goal of providing the best possible education program for
all students.   To achieve our goal, and to maximize the skills
and talents of our students, it is important that every student,
as well as employee, of our school system understand the dangers
of drug and alcohol abuse. This policy statement should clarify
our position on student drug and alcohol use. The Board reserves
the right to depart from these policies and procedures where it
deems it is appropriate. Except where specifically prohibited by
law, the guidelines contained within this document, may be
changed by the Board at any time.      Students covered by this
policy and procedures will be informed of changes.

     POLICY OBJECTIVES:

1.   To create and maintain a safe, drug-free environment for all
     students.

2.   To encourage any student with a dependence on, or addiction
     to, alcohol or other drugs to seek help in overcoming the
     problem.

3.   To reduce the likelihood of incidents of accidental personal
     injury and/or damage to students, or property.

4.   To minimize the likelihood that school property will be used
     for illicit drug activities.

5.   To protect the reputation of the school system and its
     students.

Substance abuse can be a serious threat to the school system, its
students, visitors and employees.      Though the percentage of
substance abusing students may be relatively small, practical
experience and research indicate that appropriate precautions are
necessary.   It is the belief of the Board that the benefits
derived from the policy objectives outweigh the potential
inconvenience to students.     The Board earnestly solicits the
understanding and cooperation of all students and parents,
especially those participating in extra curricular activities, in
implementing this policy.

The Board requires that all students report to school, practices
and competitive events without any alcohol or illegal or mind
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DRUG AND ALCOHOL POSSESSION AND USE

altering substances in their systems.     No student shall use
alcohol or other mood altering substances while participating in
any practices or competitive events or while under the care and
supervision of the school system. Further, outside conduct of a
substance   abuse-related  nature   which   affects  a   student
competitive or academic performance or reflects badly on the
school is prohibited.

Students must inform their coach, assistant coach, director,
sponsor, teacher, or the Board’s Medical Review Officer when they
are legitimately taking medication which may affect their ability
to practice or compete, in order to avoid creating safety
problems and violating this Drug and Alcohol Policy.


ENFORCEMENT

In order to enforce these rules, the Board reserves the right to
require all students who participate in extra curricular
activities to submit, at any time prior to, during or following a
practice or competitive event or while under the supervision or
care of this school system, to drug tests to determine the
presence of prohibited substances. All other students will submit
to drug testing with parent, guardian or custodian that is court
or Department of Human Services appointed consent. The School
Board has developed this student testing program to follow, as
appropriate, the process of 49 CFR Part 40, as amended, and the
Omnibus Transportation Employee Testing Act of 1991.

Pursuant to Board policy and regulations, students applying to
participate in extra curricular (defined as any student, male or
female, in grades five through twelve, who is a member of any
Board sponsored extra curricular activities) may be tested prior
to beginning the activity or activities of their choice.     All
current student athletes may be required to undergo testing at
scheduled physical examinations, and/or where the Board has
reasonable suspicion to believe a student athlete has violated
its Alcohol and Drug Policy, and/or on a random basis without
advance notice.

Violation of these rules, including a non-negative test result,
will subject the student suspension from student activities. A
non-negative test is any test that is positive drugs or
adulterants or any specimen that has been substituted. Refusal
to cooperate with the Board in any test investigation will result
in discipline, including immediate suspension from participating
in student athletic activities.
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                              DRUG AND ALCOHOL POSSESSION AND USE

No student testing positive (including positives for adulterants
or substituted specimens), refusing to test, refusing to
cooperate with testing or being in violation of this policy will
be penalized academically.      Information, including testing
positive, will not be released to criminal or juvenile
authorities absent compulsion by valid state or federal laws.
This policy is developed to be of a non-punitive nature and the
Board will work with the student and/or his or her parents or
guardians when there is any violation of this policy and
procedures.

All information, interviews, reports, statements, memoranda and
test results, written or otherwise, received by the Board through
its   drug  and   alcohol   testing   program  are   confidential
communications and may not be used or received in evidence,
obtained in discovery, or disclosed in any public or private
proceedings except in the following:

     (a)   As directed by the specific, written consent of the
           student authorizing release of the information to an
           identified person.
     (b)   To a covered student decision maker in a lawsuit,
           grievance, or other proceeding initiated by or on
           behalf of the individual.

Any questions should be directed to the persons assigned as the
Board's Designated School System Representatives.
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                       McComb School District
                    Policy Consent/Release Form
              Sports and Extra Curricular Activities

I have read the above statement of policy and agree to abide by
the Board's drug and alcohol rules. I agree to submit to drug
and/or alcohol tests at any time as a condition for my initial or
continued participation in student extra curricular activities.
I authorize any laboratory or medical provider to release test
results to McComb School District and its Medical Review Officer.
I authorize the Medical Review Officer to release final test
results to the Board.

I also expressly authorize the Board or its MRO to release any
test-related information, including positive results:

     (a)   As directed by my specific, written consent authorizing
           release of the information to an identified person.
     (b)   To my decision maker in a lawsuit, grievance, or other
           proceeding initiated by or on behalf of myself.

I understand that this agreement in no way limits my right to
terminate or to be terminated from McComb School District.




____________________________________    ________________________
Student Signature                       Date



___________________________________
Student Print Name



___________________________________     ________________________
Parent, Guardian or Custodian that is   Date
court or Department of Human Services
appointed


____________________________________    ________________________
Witness                                 Date
                                                                  JCDAC-7
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                                      DRUG AND ALCOHOL POSSESSION AND USE



                         McComb School District
                      Policy Consent/Release Form
                        Voluntary Parent/Student

I have read the above statement of policy and agree to abide by
the Board's drug and alcohol rules.       I agree to submit to
voluntary drug and/or alcohol tests at any time. I authorize any
laboratory or medical provider to release test results to McComb
School District and its Medical Review Officer. I authorize the
Medical Review Officer to release final test results to the
Board.

I also expressly authorize the Board or its MRO to release any
test-related information, including positive results:

     (a)   As directed by my specific, written consent authorizing
           release of the information to an identified person.
     (b)   To my decision maker in a lawsuit, grievance, or other
           proceeding initiated by or on behalf of myself.

I understand that this agreement in no way limits my right to
terminate or to be terminated from McComb School District.




____________________________________           ________________________
Student Signature                              Date



___________________________________
Student Print Name



___________________________________            ________________________
Parent, Guardian or Custodian that             Date
is court or Department of Human
Services appointed


____________________________________           ________________________
Witness                                        Date
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DRUG AND ALCOHOL POSSESSION AND USE




                       McComb School District
                      Drug and Alcohol Program
                             Procedures


I.   General Policy

Practical experience and research has proven that even small
quantities of narcotics, abused prescription drugs or alcohol can
impair judgment and reflexes which can create unsafe conditions
for students, especially those involved in extra curricular
activities. Even when not readily apparent, this impairment can
have serious results for students engaged in activities.
Drug-using students are a threat to co-participants, other
students and themselves, and may make injurious errors.       The
McComb School District has adopted a policy that all students
must report to all practice and competitive events or while under
the care of this school system completely free from the effects
of alcohol and/or the presence of drugs, unless used as
prescribed by a physician.

II. Drug Use/Distribution/Impairment/Possession

All students are prohibited from using, possessing, distributing,
manufacturing,   or   having    controlled   substances,   abused
prescription drugs, inhalants or any other mind altering or
intoxicating substances present in their system while at practice
or participating in competitive events or while under the care of
this school system.

III.   Alcohol Use/Possession/Impairment

All student are prohibited from possessing, drinking or being
impaired or intoxicated by alcohol while at practice or
participating in a competitive event or while under the care of
this school system.

IV. After School Hours Conduct

After school hours use of drugs, alcohol or any other prohibited
substances, including inhalants, is prohibited. Students should
realize that these regulations prohibit all illicit drug use –
during and away from school activities.

V.   Prescription Drugs
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                               DRUG AND ALCOHOL POSSESSION AND USE

The proper use of medication prescribed by a physician is not
prohibited; however, the McComb School District prohibits the
misuse of prescribed (or over the counter) medications and
requires all students using drugs at the direction of a physician
to notify their coach, director, sponsor, or the Board’s Medical
Review Officer where these drugs may affect their performance,
such as by causing drowsiness.


VI. Substance Screening

     A. Extra-Curricular Applicants

Substance screening is required for any student participating in
extra curricular activities. A negative result must be reported
prior to a student participating in an activity (including
practices). Such testing may be required either alone or as part
of a pre-practice or pre-participation physical examination.
Applicants are required to sign a student consent/release form
before submitting to screening. Applicants will not be allowed
to participate in any activity when they test positive for drugs
or adulterants, substitute the specimen, refuse to submit to a
test, or refuse to execute the required consent/release form.

B.    All Current Extra-curricular Participants

           1.   Reasonable Suspicion

All students participating in extra curricular activities may be
tested during the initial implementation of the program. These
students will be required to submit to screening whenever a
coach, assistant coach or school official observes circumstances
which provide reasonable suspicion to believe a student has used
alcohol or a controlled substance or has otherwise violated the
substance abuse rules. The coach’s, assistant coach’s, or school
official’s determination that reasonable suspicion exists to
require the student to undergo an alcohol and drug test must be
based on specific, contemporaneous, articulable observations
concerning the appearance, behavior, speech or body odors of the
students.

The required observations for alcohol and/or controlled substance
reasonable suspicion testing shall be made by a coach, assistant
coach, school official or designee who has been trained for at
least 60 minutes on alcohol misuse and an additional 60 minutes
on controlled substance misuse.
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DRUG AND ALCOHOL POSSESSION AND USE

The adult requiring testing shall prepare and sign written
documents explaining the circumstances and evidence upon which
they relied within 24 hours of the testing, or before the results
of the tests are released, whichever is earlier.       While one
coach, assistant coach or school official may request a
reasonable cause test, when feasible, he or she is encouraged to
obtain a second adult’s opinion as a witness.

          2.   Random Testing

The Board will conduct random unannounced screening of students.
The drug testing agency will provide computerized random sample
lists to the Designated School System Representative. The list
of students in the random pool will be updated periodically.
Students will be required to report to the Board-designated
collection site for testing as soon as possible but in no case
later than 4 hours following notification.

          3.   Return to Participation Testing

All students referred through administrative channels who undergo
a counseling or rehabilitation program or who are suspended for
abuse of substances covered under this policy will be subject to
unannounced testing following return to student activities for no
less than 12 months and no more than 60 months.

C.   Testing Procedures

          1.   General Guidelines

The School Board and its lab shall rely, when practical, on the
guidance of the federal Department of Transportation, Procedures
For Transportation Workplace Drug Testing Programs, 49 C.F.R.
Parts 40.1 through 40.413, as amended, and on the further
guidance of the Omnibus Transportation Employee Testing Act
provided in 49 C.F.R. Parts 382, 391, 392 and 395. Relative to
the protocols for determining dilute, substituted or adulterated
specimens, the school board will rely on the guidance issued by
the Substance Abuse and Mental Health Service Administration in
its program documents related to this issue.

          2.   Substances Tested For All Students

Student will regularly be tested for amphetamines, cannabinoids,
cocaine, opiates and phencyclidine.    Student may be tested for
any other substances, such as but not limited to steroids, MDMA
(ecstasy), and inhalants, without advance notice as part of tests
performed by the School Board for safety purposes.     Such tests
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                                DRUG AND ALCOHOL POSSESSION AND USE

will   be  coordinated   with    the   Designated   School   System
Representative.

          3.   Testing Procedure

The McComb School District reserves the right to utilize blood,
hair, breath, saliva or urinalysis testing procedures.      Only
urinalysis will be utilized in the pre-practice and pre-
competitive event and random testing. All initial positive urine
specimens   will   be   confirmed  by  gas   chromatography/mass
spectrometry (GC/MS).

D.   Collection Sites

The   School  Board will designate collection sites where
individuals may provide specimens.    For the most part,
collections will be conducted on-site at the appropriate
designated school.

E.   Collection Procedures

The McComb School District, Employers Drug Program Management,
and the laboratory, have developed and will maintain a documented
procedure for collecting, shipping and accessing urine specimens.
The Board, EDPM and the laboratory will utilize a standard Urine
Custody and Control Form for all extra-curricular participants’
testing. A tamper-proof sealing system, identifying numbers and
labels will also be used for specimen transportation.

Collection sites will maintain instructions and training
emphasizing the responsibility of the collection site personnel
to protect the integrity of the specimen and maintain as proper a
collection procedure as reasonable. Furthermore, all collectors
will undergo basic knowledge training, qualification training,
and an initial proficiency demonstration.    All alcohol testing
will be performed by a certified Breath Alcohol Technician (BAT).
Where the School Board has an employee collect the specimen, the
School Board will provide instruction and training to that
employee.

Students will also be required to execute the McComb School
District Applicant/Student Consent Form.

F.   Evaluations and Return of Results to the School Board

The laboratory will transmit (by fax, mail, or computer, but not
orally over the telephone) the results of all tests to the School
Board's MRO.    The MRO will be responsible for reviewing test
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DRUG AND ALCOHOL POSSESSION AND USE

results of student athletes and confirm that the individuals
testing positive have used drugs, adulterated the specimen, or
substituted the specimen in violation of the School policy. Prior
to making a final decision, the MRO shall give the individual an
opportunity to discuss the result either face to face or over the
telephone.

The   MRO  shall   then promptly tell  the  Designated  Board
Representative which student or applicants test positive for
drugs or adulterants or a substituted specimen.    The McComb
School District will then schedule a conference between the
student and parent, guardian or custodian that is court or
Department of Human Services appointed to discuss the non-
negative test result.

G.   Request for Retest

Split specimens will be collected for each drug screen.        A
student may request a retest of the split specimen within 72
hours of notification of the final test result. Requests must be
submitted to the MRO.

The students will be required to pay the associated costs of
retest in advance but will be reimbursed if the result of the
retest is negative.

H.   Release of Test Results

All information, interviews, reports, statements, memoranda and
test results, written or otherwise, received by the Board through
its   drug  and   alcohol   testing   program  are   confidential
communications and may not be used or received in evidence,
obtained in discovery, or disclosed in any public or private
proceedings except in accordance with the Policy Consent/Release
Form.

However,   all  students   will   be  required   to  execute   a
consent/release form permitting the School Board to release test
results and related information to the school officials who have
a need to know.

Parents, guardians or custodians that are court or Department of
Human Services appointed will be informed of confirmed positive
test results by the School Superintendent or Board designee.

The MRO shall retain the individual non-negative test results for
five (5) years and the negative test results for one year.
                                                         JCDAC-13
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                              DRUG AND ALCOHOL POSSESSION AND USE

VII.   Discipline

The School Board will discipline, including suspension from
activities, students for any violation of the policy, including
refusing to submit to screening, to execute a release, or
otherwise cooperate with an investigation or search by the
administration.

All students who test positive in a confirmative substance test
will be subject to discipline up to and including immediate
suspension from all student activities. Any student’s specimen
that is found by the collection site, laboratory or MRO to have
been adulterated or substituted will be considered equivalent to
a positive test.     All current students, involved in extra
curricular activities, who test positive for adulterants or a
substituted specimen will be subject to discipline up to and
including discharge.

For violations of using illegal drugs and alcohol that can be
detected by a drug test, the following penalties, which will be
cumulative from Grade 5 through Grade 12 shall be administered:

First Violation

Upon the first violation, the student shall be suspended from
participation in the event or activity in which he/she is
currently participating for a minimum of two weeks, beginning no
earlier than the opening game or event for that sport or
activity.   If a student is not participating in an in-season
sport or activity, he/she will have a two-week suspension no
earlier than the opening event of the next season in which he/she
participates.

If the violation relates to the consumption or use of a
prohibited substance, to the extent the substance is capable of
being detected by a drug test, the student cannot be reinstated
to the team, squad or activity until he/she tests negative for
that prohibited substance as a result of an approved drug test.
In the discretion of the drug testing coordinator the student may
be requested to undergo counseling.    A school counseling staff
member appointed by the Board will be provided for counseling
service.

A second option occurs when the parent, guardian or custodian
that is court or Department of Human Services appointed chooses
to seek a non-school agency for counseling.    For this service,
the parent will be responsible for paying the counseling agency,
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DRUG AND ALCOHOL POSSESSION AND USE

and shall have the agency furnish an appropriate report to the
drug testing coordinator.

Second Violation

Upon the second violation, the student will be suspended from
participating in any event or activity for the remainder of the
school year in which the second violation occurs. However, the
duration of the suspension shall be for a minimum of eight weeks
and shall carry over to the ensuring school year if necessary,
and thereby preclude such student from participating in any other
event or activity during the eight-week minimum suspension
period.

Before he/she can be reinstated to the team or squad, or
otherwise be eligible to participate in any other sport or
activity, (i) he/she must test negative for that prohibited
substance as a result of an approved drug test if the violation
relates to the consumption or use of a prohibited substance and
the substance is capable of being detected by a drug test, and
(ii) he/she shall have undergone mandatory counseling with the
Board appointed counselor as may be reasonably necessitated by
the circumstances in the discretion of the drug testing
coordinator.

A second option occurs when the parent, guardian or custodian
that is court or Department of Human Services appointed chooses
to seek a non-school agency for counseling.    For this service,
the parent will be responsible for paying the counseling agency,
and shall have the agency furnish an appropriate report to the
drug testing coordinator.

Third Violation

Upon the third violation, the student will be suspended from
participating in any event or activity for a period extending for
a full calendar year.

Before he/she can be reinstated to the team or squad, or
otherwise be eligible to participate in any other activity, (i)
he/she must test negative for that prohibited substance as a
result of an approved drug test if the violation relates to the
consumption or use of a prohibited substance and the substance is
capable of being detected by a drug test, and (ii) he/she shall
have undergone mandatory counseling with the Board appointed
counselor as may be reasonably necessitated by the circumstances
in the discretion of the drug testing coordinator.
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A second option occurs when the parent, guardian or custodian
that is court or Department of Human Services appointed chooses
to seek a non-school agency for counseling.    For this service,
the parent will be responsible for paying the counseling agency,
and shall have the agency furnish an appropriate report to the
drug testing coordinator.

Fourth Violation

Upon the fourth violation, the student will be indefinitely
suspended or permanently barred from participating in any event
or activity in the McComb School District school system.

The school shall continue to offer the “barred” student
counseling service as may be reasonably necessitated by the
circumstances in the discretion of the drug testing coordinator.

No student may be returned to regular student activities after
any rehabilitation or testing positive unless certified as safe
and not using drugs by having a negative result on a return-to-
participation screen.     Any student returned to duty after
violating the policy or testing positive will be subject to
aftercare and random testing as set out in a written Probation
Agreement, which he or she will be required to execute.

VIII. Student Assistance Program (EAP)

The Board’s EAP shall include education and training for coaches,
assistant coaches, sponsors, directors and school officials who
are authorized to determine reasonable suspicion testing. These
adults must receive a minimum of 60 minutes on alcohol abuse and
an additional 60 minutes of training on controlled substance use
and abuse.

The training shall cover the physical, behavioral, speech and
performance indicators of probable use and misuse of alcohol and
controlled substances. Documentation of training attendance must
be maintained.

The Designated School System Representative should be contacted
for further guidance.

IX.   Investigation/Searches

Where a school official has reasonable cause to suspect that a
student has violated the substance abuse policy, he or she may
inspect vehicles which a student brings on the Board’s property,
lockers, purses, book bags, or other belongings, and at locations
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DRUG AND ALCOHOL POSSESSION AND USE

where school related activities are being conducted without prior
notice in order to ensure a school environment free of prohibited
substances. A student may be asked to be present and remove a
personal lock.   Where the student is not present or refuses to
remove a personal lock, a school official will do so for him or
her.

Detection of prohibited substances from authorized searches will
be communicated to the Designated School System Representative.

X.    Urine Collection Procedures

1.    The students will report to a designated location for
      collection of urine samples.
2.    The student will provide a urine sample under supervision of
      trained individuals.
3.    If a student is unable to provide urine at the designated
      time, an additional four hours will be allowed to produce
      urine sample.   During this time the student will be given
      water to drink.   If after four hours the student is still
      unable to provide a sample, it will be reconsidered as a
      refusal to test.
4.    The student will take a sample collection container and
      provide required amount of urine.
5.    The student must bring the sample back to the control
      station administration room.
6.    The student will be given a sampling kit.
7.    The student will put urine in sample kit.
8.    The student will seal the kit and give to sampling
      administrator.
9.    The sampling administrator will record information on the
      sample collection form.    The student will check that this
      information is correct.
10.   The student will be asked to declare any medication that
      they may have taken.
11.   Once the student is satisfied that the information is
      accurate they will sign the form.
12.   The student will be free to leave.
13.   The parent, guardian or custodian that is court or
      Department of Human Services appointed and student shall be
      notified if test result is positive.
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                              DRUG AND ALCOHOL POSSESSION AND USE




                     McComb School District
                      Student Consent Form




     I, ___________________________________, do hereby give my
consent to the School Board to collect a urine, breath, hair
and/or blood sample from me on this date, and I further give my
consent to the School Board to forward the sample(s) to the
testing laboratory for its performance of appropriate tests
thereon to identify the presence of drugs and/or alcohol.      I
further give the laboratory my permission to release the results
of such tests to the School Board's Medical Review Officer if
appropriate. I understand that the refusal to submit to testing
or a positive test result will affect my initial or continued
participation in student athletic programs for McComb School
District and result in disciplinary action as described in the
School Board's Drug and Alcohol Policy.




____________________________________     ________________________
Student Signature                        Date



____________________________________     ________________________
Parent, Guardian or court or
Department of Human Services appointed   Date
Custodian

				
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