CONCUSSION CODE OF CONDUCT FOR ATHLETES AND

PARENTS/GUARDIANS (for athletes under age 18)

I will help prevent concussions by:

  • Wearing the proper equipment for my sport and wearing it correctly.
  • Developing my skills and strength so that I can participate to the best of my ability.
  • Respecting the rules of my sport or activity.
  • My commitment to fair play and respect for all (respecting other athletes, coaches, and officials).*

I will care for my health and safety by taking concussions seriously, and I understand that:

  • A concussion is a brain injury that can have both short- and long-term effects.
  • A blow to my head, face or neck, or a blow to the body that causes the brain to move around inside the skull may cause a concussion.
  • I don’t need to lose consciousness to have had a concussion.
  • I have a commitment to concussion recognition and reporting, including self-reporting of possible concussion and reporting to a designated person when an individual suspects that another individual may have sustained a concussion.*
    (Meaning: If I think I might have a concussion I should stop participating in further training, practice or competition     immediately, or tell an adult if I think another athlete has a concussion).
  • Continuing to participate in further training, practice or competition with a possible concussion increases my risk of more severe, longer lasting symptoms, and increases my risk of other injuries.

I will not hide concussion symptoms. I will speak up for myself and others.

  • I will not hide my symptoms. I will tell a coach, official, team trainer, parent or another adult I trust if I experience any symptoms of concussion.
  • If someone else tells me about concussion symptoms, or I see signs they might have a concussion, I will tell a coach, official, team trainer, parent or another adult I trust so they can help.
  • I understand that if I have a suspected concussion, I will be removed from sport and that I will not be able to return to training, practice or competition until I undergo a medical assessment by a medical doctor or nurse practitioner and have been medically cleared to return to training, practice or competition.  
  • I have a commitment to sharing any pertinent information regarding incidents of removal from sport with the athlete’s school and any other sport organization with which the athlete has registered* (Meaning: If I am diagnosed with a concussion, I understand that letting all of my other coaches and teachers know about my injury will help them support me while I recover.)

I will take the time I need to recover, because it is important for my health.

  • I understand my commitment to supporting the return-to-sport process*
    (I will have to follow my sport organization’s Return-to-Sport Protocol).
  • I understand I will have to be medically cleared by a medical doctor or nurse practitioner before returning to training, practice or competition.
  • I will respect my coaches, team trainers, parents, health-care professionals, and medical doctors and nurse practitioners, regarding my health and safety.

By signing here, I acknowledge that I have fully reviewed and commit to this Concussion Code of Conduct.

Athlete (Print Name): _____________________      

Athlete (Signature): ______________________

Parent/Guardian (of athletes who are under 18 y.o.)

Signature: _____________________________

Date:  _____________________

Medical Profile for Participants 17 and Under

Participant’s Name

Participant’s Birthdate

Allergies

Medications

Medical History (including previous concussions/blows to the head/face/neck and the dates they occurred)

Any comments/concerns

I understand that, in the event that no one can be contacted, the Curling club staff or volunteers will call 911 if deemed necessary. I also understand that under no circumstances is the Curling Club or its staff or volunteers, liable or responsible for the treatment of said injured or ill player. I hereby authorize the physician and nursing staff on duty at any emergency unit to undertake examination, investigation, and necessary treatment of my child.

Parent/Guardian Name (Print)

Parent/Guardian Signature

Date