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CONCUSSION ACKNOWLEDGEMENT AND SIGNATURE FORM FOR PARENTS AND STUDENT ATHLETES Student Athlete s Name (Please Print): Sport Participating In (If Known): Date: IC 20-34-7 Student Athletes: Concussions
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How to fill out concussion acknowledgement and signature:

01
Read the concussion acknowledgement form thoroughly. Make sure you understand the purpose and importance of the form.
02
Provide your personal information accurately. This may include your full name, age, contact information, and any other details required in the form.
03
Review the concussion information provided. Understand the symptoms, risks, and potential consequences of concussions.
04
Sign the acknowledgement section. This signifies that you have read and understood the provided information regarding concussions.

Who needs concussion acknowledgement and signature:

01
Athletes: Concussion acknowledgement forms are commonly required for athletes participating in sports activities. This is to ensure their awareness and understanding of the risks associated with concussions.
02
Coaches and Trainers: Those responsible for overseeing sports activities may also need to sign concussion acknowledgement forms. This demonstrates their commitment to promoting safety and proper concussion protocols.
03
Parents or Legal Guardians: If the individual filling out the form is a minor, their parents or legal guardians may be required to sign the concussion acknowledgement form on their behalf.
Overall, anyone involved in sports or activities where there is a risk of head injuries should complete a concussion acknowledgement and signature form to ensure awareness, understanding, and commitment to proper protocols.
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Concussion acknowledgement and signature is a form that confirms an individual's understanding and acceptance of the risks associated with concussions in a specific activity or sport.
Participants, coaches, officials, and parents/guardians of minors are typically required to file concussion acknowledgement and signature.
The form typically requires the individual to read information about concussions, acknowledge the risks, and sign to confirm their understanding and acceptance.
The purpose of the concussion acknowledgement and signature is to educate individuals about the risks of concussions and to ensure that they are aware of the signs and symptoms.
The form may require personal information of the individual, confirmation of understanding of concussion risks, and a signature.
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