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CONCUSSION ACKNOWLEDGEMENT AND SIGNATURE FORM FOR PARENTS/GUARDIANS & STUDENT ATHLETES Student Athlete s Name (Please Print): Sport(s) Participating In (If Known): Date: With the enactment of the
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How to fill out concussion acknowledgement and signature:

01
Obtain the concussion acknowledgement and signature form from the appropriate organization or institution.
02
Read the form carefully and ensure that you understand all the information provided.
03
Fill out your personal information, such as your full name, date of birth, and contact details, in the designated fields.
04
Review the description of concussion-related risks, symptoms, and potential consequences provided on the form.
05
Acknowledge your understanding of the information by signing and dating the form.
06
If required, provide additional signatures or information, such as a parent or guardian's signature for minors.
07
Submit the completed form to the relevant party, following any instructions provided.

Who needs concussion acknowledgement and signature:

01
Athletes and participants in organized sports activities.
02
Students participating in school sports programs or physical education classes.
03
Employees or volunteers involved in jobs or roles that pose a risk of head injuries, such as construction workers, healthcare professionals, or military personnel.
04
Individuals taking part in recreational activities or events that may carry a risk of head injuries, such as extreme sports, adventure tourism, or outdoor activities.
05
Organizations or institutions that prioritize the safety and well-being of their members or participants by ensuring that they are aware of the risks associated with concussions.
06
Legal entities that require documentation to protect themselves from liability in case of a concussion-related incident.
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Concussion acknowledgement and signature is a form that must be signed by individuals to confirm their understanding and acceptance of the risks associated with concussions.
Athletes, coaches, and parents/guardians of minor athletes are typically required to file concussion acknowledgement and signature.
To fill out concussion acknowledgement and signature, individuals must read the form carefully, provide any required information, and sign the document to indicate their agreement.
The purpose of concussion acknowledgement and signature is to ensure that individuals are aware of the risks of concussions in sports and agree to follow safety protocols.
Concussion acknowledgement and signature typically require individuals to acknowledge their understanding of concussion risks, symptoms, and protocols for reporting and managing concussions.
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