All forms need to be printed, signed and returned to your school's Athletic Director
*If you need a paper copy of these forms, contact your school's Athletic Director
Sport Playing
*
Student Concussion Videos
Students must watch BOTH videos, then sign and date below.
Concussion Video #1
Concussion Video #2
I have viewed both Concussion videos. I understand that any infraction of these rules may result in suspension or non-participation in said sport.
*
Yes
Name
*
First Name
Last Name
Student Signature
*
Date
*
-
Month
-
Day
Year
Date
Parent Concussion Video
Parent/Legal Guardian must watch the Concussion video then sign and date below.
Parent Concussion Video
I have viewed the Concussion video. I understand that any infraction of these rules may result in suspension or non-participation in said sport.
*
Yes
Parent/Legal Guardian Name
*
First Name
Last Name
Parent/Legal Guardian Signature
*
Date
*
-
Month
-
Day
Year
Date
Back
Next
Risk Management Video
Student and Parent/Legal Guardian must watch this video, sign and date below.
Risk Management Video
Student: I have viewed the Risk Management video. I understand that any infraction of these rules may result in suspension or non-participation in said sport.
*
Yes
Student Name
*
First Name
Last Name
Student Signature
*
Date
*
-
Month
-
Day
Year
Date
Parent/Legal Guardian: I have viewed the Risk Management video.
*
Yes
Parent/Legal Guardian Name
*
First Name
Last Name
Parent/Legal Guardian Signature
*
Date
*
-
Month
-
Day
Year
Date
Back
Next
Contact Information
Parent/Legal Guardian
*
First Name
Last Name
Parent/Legal Guardian Email
*
example@example.com
Parent/Legal Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Submit
Should be Empty: