University Interscholastic League
School Year (to be completed annually) ______________
Parent and Student Agreement/Acknowledgement Form
Anabolic Steroid Use and Random Steroid Testing
Texas state law prohibits possessing, dispensing, delivering or administering a steroid in a
manner not allowed by state law.
Texas state law also provides that body building, muscle enhancement or the increase in muscle
bulk or strength through the use of a steroid by a person who is in good health is not a valid
medical purpose.
Texas state law requires that only a licensed practitioner with prescriptive authority may prescribe
a steroid for a person.
Any violation of state law concerning steroids is a criminal offense punishable by confinement in
jail or imprisonment in the Texas Department of Criminal Justice.
STUDENT ACKNOWLEDGEMENT AND AGREEMENT
As a prerequisite to participation in UIL athletic activities, I agree that I will not use anabolic steroids as
defined in the UIL Anabolic Steroid Testing Program Protocol. I have read this form and understand that I
may be asked to submit to testing for the presence of anabolic steroids in my body, and I do hereby
agree to submit to such testing and analysis by a certified laboratory. I further understand and agree that
the results of the steroid testing may be provided to certain individuals in my high school as specified in
the UIL Anabolic Steroid Testing Program Protocol which is available on the UIL website at
www.uil
texas.org. I understand and agree that the results of steroid testing will be held confidential to
the extent required by law. I understand that failure to provide accurate and truthful information could
subject me to penalties as determined by UIL.
Student Name (Print): ___________________________________________ Grade (9-12) _______
Student Signature: _____________________________ Date: ___________
PARENT/GUARDIAN CERTIFICATION AND ACKNOWLEDGEMENT
As a prerequisite to participation by my student in UIL athletic activities, I certify and acknowledge that I
have read this form and understand that my student must refrain from anabolic steroid use and may be
asked to submit to testing for the presence of anabolic steroids in his/her body. I do hereby agree to
submit my child to such testing and analysis by a certified laboratory. I further understand and agree that
the results of the steroid testing may be provided to certain individuals in my student’s high school as
specified in the UIL Anabolic Steroid Testing Program Protocol which is available on the UIL website at
www.uil
texas.org. I understand and agree that the results of steroid testing will be held confidential to
the extent required by law. I understand that failure to provide accurate and truthful information could
subject my student to penalties as determined by UIL.
Name (Print): ___________________________________________
Signature: _____________________________ Date: ___________
Relationship to student: ___________________________________
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