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Burlington High School Activities Department Emergency×Concussion Information and Consent Form (This form needs to be completed, signed and returned to the BHS Activities Office BEFORE starting practice.)
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How to fill out emergencyconcussioninsurance student activity form

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How to fill out the emergency concussion insurance student activity form:

01
Obtain the form from the school or organization that requires it.
02
Read through the entire form carefully to understand its purpose and the information it requires.
03
Begin by filling out the personal information section, which typically includes your name, date of birth, address, and contact information.
04
Move on to the insurance information section. Provide details about your current insurance coverage, including the insurance company's name, policy number, and contact information.
05
Fill out the emergency contact section. This should include the name, relationship, phone number, and address of at least one emergency contact person who can be reached in case of an accident or emergency.
06
Look for any sections related to specific activities or sports participation. If you are participating in any activities that may have a higher risk of injury, you may need to provide additional information or obtain parental consent.
07
Review the entire form once you have completed it to ensure all the information is accurate and legible.
08
Sign and date the form as required.
09
Return the completed form to the designated person or office before the specified deadline.

Who needs the emergency concussion insurance student activity form:

01
Students who are participating in school-sponsored or organized activities, such as sports teams, clubs, or field trips, may be required to fill out this form.
02
The form helps schools and organizations ensure that students have appropriate insurance coverage in case of a concussion or other injury during these activities.
03
It is important for students who regularly participate in sports or activities with a higher risk of injury to have this form on file.
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Emergency Concussion Insurance Student Activity Form is a document that collects information about student athletes and their insurance coverage in case of a concussion during a school activity.
Student athletes who participate in school activities or sports programs are required to file the Emergency Concussion Insurance Student Activity Form.
The form can be filled out by providing the necessary information about the student athlete, their insurance coverage, emergency contacts, and any relevant medical history.
The purpose of the form is to ensure that student athletes have proper insurance coverage in case of a concussion during a school activity, and to have emergency contacts and medical information readily available.
The form typically requires information such as student athlete's name, insurance provider, policy number, emergency contacts, any known medical conditions or allergies, and consent for emergency medical treatment.
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