Watertown Park & Recreation DepartmentConcussion Agreement • January 28th, 2022
As a Parent and as an Athlete it is important to recognize the signs, symptoms, and behav- iors of concussions. By signing this form you are stating that you understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head inju- ry.
PARENT & ATHLETE CONCUSSION AGREEMENTConcussion Agreement • September 20th, 2020
As a Parent and as an Athlete it is important to recognize the signs, symptoms, and behaviors of concussions. By signing this form, you are stating that you understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head injury. This form must be on file for every sports season and every youth athletic organization the athlete is involved with and must be renewed each school year (clubs- every 365 days).
Watertown Park & Recreation DepartmentConcussion Agreement • January 16th, 2024
As a Parent and as an Athlete it is important to recognize the signs, symptoms, and behav- iors of concussions. By signing this form you are stating that you understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head inju- ry.
Fellowship Baptist ChurchConcussion Agreement • May 4th, 2016
As a Parent and as an Athlete it is important to recognize the signs, symptoms, and behaviors of concussions. By signing this form you are stating that you understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head injury.
PARENT & ATHLETE ATHLETIC HANDBOOK/CONCUSSIONConcussion Agreement • February 11th, 2021
concussions. By signing this form you are stating that you understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head injury. This form must be completed for every sports season and every youth athletic organization the athlete is involved with.
Northern Kentucky Youth Association Concussion AgreementConcussion Agreement • December 22nd, 2021
Hoehne School Concussion AgreementConcussion Agreement • January 20th, 2021
any athlete who exhibits signs, symptoms, or behaviors consistent with a concussion (such as loss of consciousness, headache, dizziness, confusion, or balance problems) shall be immediately removed from participation and shall not return to play until cleared by a licensed healthcare practitioner (Doctor of Medicine, Doctor of Osteopathic Medicine, Licensed Nurse Practitioner, Licensed Physician Assistant, or Licensed Doctor of Psychology with Training in Neuropsychology or Concussion Evaluation and Management).
Parent/Athlete Concussion Agreement FormConcussion Agreement • January 29th, 2014
As a Parent and as an Athlete it is important to recognize the signs, symptoms, and behaviors of concussions. By signing this form you are stating that you understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head injury.
PARENT & ATHLETE CONCUSSION AGREEMENTConcussion Agreement • November 3rd, 2020
Wis. State Statute: At the beginning of a season for a youth athletic activity, the person operating the youth athletic activity shall distribute a concussion and head injury information sheet to each person who will be coaching that youth athletic activity and to each person who wishes to participate in that youth athletic activity. No person may participate in a youth athletic activity unless the person returns the information sheet signed by the person and, if he or she is under the age of 19, by his or her parent or guardian.
RETURN TO RICHMOND ATHLETIC DIRECTOR(S)Concussion Agreement • April 4th, 2022
EYGB Parent and Athlete Concussion AgreementConcussion Agreement • September 21st, 2016
As a Parent and as an Athlete it is important to recognize the signs, symptoms, and behaviors of concussions. By signing this form you are stating that you understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head injury.
Parent and Athlete Concussion AgreementConcussion Agreement • August 13th, 2012
As a parent and as an athlete it is important to recognize the signs, symptoms, and behaviors of concussions. By signing this form, you are stating that you understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head injury.
PARENT & ATHLETE CONCUSSION AGREEMENTConcussion Agreement • November 9th, 2012
As a Parent and as an Athlete it is important to recognize the signs, symptoms, and behaviors of concussions. By signing this form you are stating that you understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head injury. This form must be completed for every sports season and every youth athletic organization the athlete is involved with.
Watertown Park & Recreation DepartmentConcussion Agreement • January 16th, 2023
As a Parent and as an Athlete it is important to recognize the signs, symptoms, and behav- iors of concussions. By signing this form you are stating that you understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head inju- ry.
WHITMAN MIDDLE SCHOOLConcussion Agreement • August 15th, 2014
It is important for parents/guardians and athletes to recognize the signs, symptoms and behaviors of concussions. By signing this form, you are stating that you have read and understood the information regarding parent, coach and athlete awareness regarding concussions and head injuries.
CONCUSSION AGREEMENTConcussion Agreement • September 7th, 2016
A concussion is a type of brain injury that changes the way the brain normally works. A concussion is caused by a bump, blow, or jolt to the head. Concussions can also occur from a blow to the body that causes the head and brain to move rapidly back and forth. Even what seems to be a mild bump to the head can be serious. Concussions can occur during practices or games in any sport or recreational activity. Your chances of sustaining a life altering injury are greatly increased if you aren`t fully recovered from a concussion. Practicing/playing with concussion symptoms can prolong your recovery. Practicing/playing with a concussion can increase your chances of getting another concussion. Telling someone could save your life or the life of a teammate.
PARENT & ATHLETE CONCUSSION AGREEMENTConcussion Agreement • August 6th, 2012
As a Parent and as an Athlete it is important to recognize the signs, symptoms, and behaviors of concussions. By signing this form you are stating that you understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head injury.
Parent and Athlete Concussion AgreementConcussion Agreement • May 18th, 2016
Statement Acknowledging Receipt of Education and Responsibility to report signs or symptoms of concussion to be included as part of the “Participant and Parental Disclosure and Consent Document.”
Watertown Park & Recreation Department Parent & Athlete Concussion Agreement Sport: Concussion Agreement • August 24th, 2012
As a Parent and as an Athlete it is important to recognize the signs, symptoms, and behaviors of concussions. By signing this form you are stating that you understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head injury.
Caroline Middle School Athletic Concussion Agreement FormConcussion Agreement • May 2nd, 2018
As a Parent and as an Athlete it is important to recognize the signs, symptoms, and behaviors of concussions. By signing this form you are stating that you understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head injury. I have read and signed the “Heads Up Concussion” form.
PARENT & ATHLETE CONCUSSION AGREEMENTConcussion Agreement • March 28th, 2018
As a Parent and as an Athlete it is important to recognize the signs, symptoms, and behaviors of concussions. By signing this form you are stating that you understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head injury. This form must be on file for every sports season and every youth athletic organization the athlete is involved with and must be renewed each school year (clubs‐ every 365 days).
Lake Country SchoolConcussion Agreement • August 1st, 2013
As a Parent and as an Athlete it is important to recognize the signs, symptoms, and behaviors of concussions. By signing this form you are stating that you understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head injury. This form must be completed for every student-athlete prior to participation in an athletic activity.
WYSC’s Concussion AgreementConcussion Agreement • June 26th, 2015
As a Parent and as an Athlete it is important to recognize the signs, symptoms, and behaviors of concussions. By signing this form you are stating that you understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head injury and have completed the required ImPACT Baseline test. This form must be on file for every player each year the athlete is involved with the club. The ImPACT Baseline test must be taken once a year for players 10-12 and every other year for players 13 and up.
Parent & Athlete Concussion AgreementConcussion Agreement • May 30th, 2019
As a Parent and as an Athlete, it is important to recognize the signs, symptoms, and behaviors of concussions. By signing this form you are stating that you understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head injury.
SJB PARENT & ATHLETE CONCUSSION AGREEMENTConcussion Agreement • August 19th, 2014
As a Parent and as an Athlete it is important to recognize the signs, symptoms, and behaviors of concussions. By signing this form you are stating that you understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head injury.
