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Concussion Waiver
A concussion is a brain injury and all brain injuries are serious. They are caused by a bump, blow, or jolt to the head, or by a blow to another part of the body with the force transmitted to the head. They can range from mild to severe and can disrupt the way the brain normally works. Even though most concussions are mild, all concussions are potentially serious and may result in complications including prolonged brain damage and death if not recognized and managed properly. In other words, even a “ding” or a bump on the head can be serious. You can’t see a concussion and most sports concussions occur without loss of consciousness. Signs and symptoms of concussion may show up right after the injury or can take hours or days to fully appear. If your child reports any symptoms of concussion, or if you notice the symptoms or signs of concussion yourself, seek medical attention right away.
Symptoms may include one or more of the following:
| ● Headaches ● Pressure in head” ● Nausea or vomiting ● Neck pain ● Balance problems or dizziness ● Blurred, double, or fuzzy vision ● Sensitivity to light or noise ● Feeling sluggish or slowed down ● Feeling foggy or groggy ● Drowsiness ● Change in sleep patterns ● Amnesia ● “Don’t feel right” ● Fatigue or low energy ● Sadness ● Nervousness or anxiety ● Irritability ● More emotional ● Confusion ● Concentration or memory problems (forgetting game plays) ● Repeating the same question/comment |
Signs observed by teammates, parents and coaches include:
| ● Appears dazed ● Vacant facial expression ● Confused about assignment ● Forgets plays ● Is unsure of game, score, or opponent ● Moves clumsily or displays incoordination ● Answers questions slowly ● Slurred speech ● Shows behavior or personality changes ● Can’t recall events prior to hit ● Can’t recall events after hit ● Seizures or convulsions ● Any change in typical behavior or personality ● Loses consciousness |
What can happen if my child keeps on playing with a concussion or returns too soon?
Athletes with the signs and symptoms of concussion should be removed from play immediately. Continuing to play with the signs and symptoms of a concussion leaves the young athlete especially vulnerable to greater injury. There is an increased risk of significant damage from a concussion for a period of time after that concussion occurs, particularly if the athlete suffers another concussion before completely recovering from the first one. This can lead to prolonged recovery, or even to severe brain swelling (second impact syndrome) with devastating and even fatal consequences. It is well known that adolescent or teenage athletes will often fail to report symptoms of injuries .Concussions are no different.
As a result, education of administrators, directors, coaches, parents and athletes is the key to athlete’s safety. If you think your child has suffered a concussion any athlete even suspected of suffering a concussion should be removed from the game or practice immediately. No athlete may return to activity after an apparent head injury or concussion, regardless of how mild it seems or how quickly symptoms clear, without medical clearance.
it’s better to miss one game than miss the whole season. And when in doubt, the athlete sits out.
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 certify that you have read, and understand, and agree to abide by all of the information contained in this sheet.
You further certify that if you have not understood any information contained in this document, you have sought and received an explanation of the information prior to signing this statement.
Parent Agreement:
I have read the Parent Concussion and Head Injury Information and understand what a concussion is and how it may be caused.
I also understand the common signs, symptoms, and behaviors. I agree that my child must be removed from practice/play if a concussion is suspected. I understand that it is my responsibility to seek medical treatment if a suspected concussion is reported to me.
I understand that my child cannot return to practice/play until providing written clearance from an appropriate health care provider to his/her coach. I understand the possible consequences of my child returning to practice/play too soon.
By pressing continue below I acknowledge that I have read and agree to the concussion waiver outlined above.