Form 02-3d						Academic Year 2002-03

			Drug-Testing Consent  Division I
					
For:	Student-athletes	
Action:	Sign and return to your director of athletics	
Due date:	In sports in which the Association conducts year-round drug-testing, at the time your intercollegiate squad first reports for practice or before the Monday of your institution's fourth week of classes (whichever date occurs first).

In sports in which the Association does not conduct year-round drug testing, before the institution's first scheduled intercollegiate competition.	
Required by:		NCAA Constitution 3.2.4.6 and NCAA Bylaws 14.1.4 and 30.5	
Purpose:	To assist in certifying eligibility	

TO:  STUDENT-ATHLETE

Name of your institution: _________________________________________________________

You must sign this form to participate (i.e., practice or compete) in intercollegiate athletics.  Per NCAA Bylaw 30.5-(b), the director of athletics or the director of athletics’ designee shall disseminate a copy of the list of banned drug classes to each student-athlete (Attachment A of this form).

NCAA Constitution 3.2.4.6 and NCAA Bylaws 14.1.4 and 30.5 require that you sign this form.  If you have any questions, you should discuss them with your director of athletics.

Drug-Testing Consent

By signing this form, you affirm that you are aware of the NCAA drug-testing program, which provides:

A student-athlete who is found to have used a substance on the list of banned drugs, as set forth in Bylaw 31.2.3.1, shall be declared ineligible for further participation in regular season and postseason competition in all sports in accordance with the provisions in Bylaw 18.4.1.5.1.  The certifying institution may appeal to the NCAA Student-Athlete Reinstatement Committee for restoration of the student-athlete's eligibility if the institution concludes that circumstances warrant restoration.  (Bylaw 18.4.1.5)

A student-athlete who tests positive (in accordance with the testing methods authorized by the NCAA Executive Committee) shall be ineligible to participate in regular-season and postseason competition for one calendar year (i.e., 365 days) after the positive drug test and shall be charged with the loss of a minimum of one season of competition in all sports.  The student-athlete shall remain ineligible for all regular-season and postseason competition for one calendar year after the student-athlete's positive drug test, and until the student-athlete retests negative (in accordance with the testing methods authorized by the Executive Committee) and the student-athlete's eligibility is restored by the Student-Athlete Reinstatement Committee.  If a student-athlete transfers to another NCAA institution while ineligible due to a positive NCAA drug test, the institution from which the student-athlete transfers must notify the transfer institution regarding the positive drug test result.

If the student-athlete tests positive a second time for the use of any drug, other than a "street drug" as defined in Bylaw 31.2.3.1, he or she shall lose all remaining regular-season and postseason eligibility in all sports.  In addition, the penalty for missing a scheduled drug test is the same as the penalty for testing positive for the use of a banned drug.

If the student-athlete tests positive for the use of a "street drug" after being restored to eligibility, he or she shall be charged with the loss of a minimum of one additional season of competition in all sports and also shall remain ineligible for regular-season and postseason competition at least through the next calendar year.  If the student-athlete transfers to another NCAA institution while ineligible, the institution from which the student-athlete transferred must notify the institution that the student-athlete is ineligible due to a positive drug test result.  If the student-athlete immediately transfers to a non-NCAA institution while ineligible and competes in collegiate competition within the 365-day period at a non-NCAA institution, the student-athlete will be ineligible for all NCAA regular-season and postseason competition until the student-athlete does not compete in collegiate competition for a 365-day period.  Additionally, the student-athlete must retest negative (in accordance with the testing methods authorized by the Executive Committee) and request that eligibility be restored by the Academic/Eligibility/Compliance Cabinet.  (Bylaw 18.4.1.5.1)

The Executive Committee shall adopt a list of banned drugs and shall authorize methods for drug testing of student-athletes on a year-round basis.  This list of banned drugs and the procedure for informing member institutions about authorized methods for drug testing are set forth in Bylaws 31.2.3.1 and 31.2.3.3 respectively.  The list is subject to change and the institution and student-athlete shall be held accountable for all banned drug classes on the current list (see Attachment A of this form).  The list is located on the NCAA web site (www.ncaa.org) or may be obtained from the NCAA health and safety staff in Education Outreach.  (Bylaw 18.4.1.5.2)

You agree to allow the NCAA to test you in relation to any participation by you in any NCAA championship or in any postseason football game certified by the NCAA for the banned drugs listed in Bylaw 31.2.3.1.  Additionally, if you participate in Division I football or track and field, you also agree to be tested on a year-round basis for anabolic agents, diuretics, ephedrine and urine manipulators.
You were provided an opportunity to review the procedures for NCAA drug testing that are described in the NCAA Drug-Testing Program brochure.

You understand that this consent and the results of your drug tests, if any, only will be disclosed in accordance with the provisions of the Buckley Amendment consent.

You agree to disclose your drug-testing results only for purposes related to your eligibility for participation in regular-season and postseason competition.

You affirm that you understand that if you sign this statement falsely or erroneously, you violate NCAA legislation on ethical conduct, and you will further jeopardize your eligibility.

_______________________	          _________________________________________________
Date						Signature of student-athlete

_______________________	          _________________________________________________
Date						Signature of Parent (if student-athlete is a minor)

_________________________________________		__________________      _________
Name (please print)					Date of Birth			Age

_____________________________________________________________________________Home Address

______________________________________________________________________________Sport(s)

What to do with this form:  Sign and return it to your director of athletics at the time your intercollegiate squad first reports for practice or before the Monday of your institution's fourth week of classes, whichever date occurs first.  This form is to be kept in the director of athletics office for six years.

Attachment A

NCAA Banned Drugs

*Per NCAA Bylaw 30.5-(b), the director of athletics or the director of athletics’ designee shall disseminate a copy of the list of banned drug classes to each student-athlete.

Please note that the list of banned drugs is subject to change by the NCAA Executive Committee, and the institution and student-athlete shall be held accountable for all banned drug classes on the current list.  Updates to the list of banned drugs can be found via the NCAA web site (www.ncaa.org).

The term "related compounds" comprises substances that are included in the class by their pharmacological action and/or chemical structure. 

No substance belonging to the prohibited class may be used, regardless of whether it is specifically listed as an example.

The following is the list of banned-drug classes, pursuant to NCAA Division I Bylaw 31.2.3.1.

(a) Stimulants:

amiphenazole 
amphetamine 
bemigride 
benzphetamine 
bromantan 
caffeine1 
chlorphentermine 
cocaine 
cropropamide 
crothetamide 
diethylpropion 
dimethylamphetamine	doxapram 
ephedrine 
ethamivan 
ethylamphetamine 
fencamfamine 
meclofenoxate 
methamphetamine 
methylene-dioxymethamphetamine (MDMA, also known as Ecstasy)
methylphenidate 
nikethamide 
pemoline	pentetrazol 
phendimetrazine 
phenmetrazine 
phentermine 
phenylpropanolamine (PPA)
picrotoxine 
pipradol 
prolintane 
strychnine 
and related compounds *	

(b) Anabolic Agents:

anabolic steroids 
androstenediol 
androstenedione 
boldenone 
clostebol 
dehydrochlormethyl-testosterone 
dehydroepiandrosterone (DHEA) 
dihydrotestosterone (DHT) 
dromostanolone 
 	fluoxymesterone 
mesterolone 
methandienone 
methenolone 
methyltestosterone 
nandrolone 
norandrostenediol 
norandrostenedione 
norethandrolone 
	oxandrolone 
oxymesterone 
oxymetholone 
stanozolol 
testosterone2 
and related compounds*
Other anabolic agents 
clenbutero	

(c) Substances Banned for Specific Sports:

Rifle: 

alcohol 
atenolol 
metoprolol 
	nadolol 
pindolol 
propranolol 
	timolol 
and related compounds *	

(d) Diuretics:

acetazolamide 
bendroflumethiazide 
benzthiazide 
bumetanide 
chlorothiazide 
chlorthalidone 
ethacrynic acid 
	flumethiazide 
furosemide 
hydrochlorothiazide 
hydroflumethiazide 
methyclothiazide 
metolazone 	polythiazide 
quinethazone 
spironolactone 
triamterene 
trichlormethiazide 
and related compounds *	

(e) Street Drugs:

heroin 
	marijuana3 
	THC (tetrahydrocannabinol)3	

(f) Peptide Hormones and Analogues

chorionic gonadotrophin (HCG - human chorionic gonadotrophin) 
corticotrophin (ACTH) 
growth hormone (HGH, somatotrophin) 
*All the respective releasing factors of the 
above-mentioned substances also are banned.
erythropoietin (EPO) 	
sermorelin

(g) Definitions of positive depends on the following:

1 for caffeine-if the concentration in urine exceeds 15 micrograms/ml. 
2 for testosterone-if the administration of testosterone or the use of any other manipulation has the result of increasing the ratio of the total concentration of testosterone to that of epitestosterone in the urine to greater than 6:1, unless there is evidence that this ratio is due to a physiological or pathological condition.
3 for marijuana and THC-if the concentration in the urine of THC metabolite exceeds 15 nanograms/ml.
* The term "related compounds" comprises substances that are included in the class by their pharmacological action and/or chemical structure. No substance belonging to the prohibited class may be used, regardless of whether it is specifically listed as an example.

Supplements

Nutritional supplements are not strictly regulated and may contain substances banned by the NCAA.  For questions regarding nutritional supplements, please visit the National Center for Drug Free Sport Resource Exchange Center (REC) Web site (www.drugfreesport.com/rec).