Pre-Participation Head Injury/Concussion Reporting Form for Fall Sports 2017
This form should be completed by the student's parent(s) or legal guardian(s). It must be submitted prior to the start of each season a student plans to participate in extracurricular athletics.
Student's First Name
Student's Last Name
Date of Birth
What grade are you in?
What sport are you trying out for?
Has the student ever experienced a traumatic blow to the head?
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This form was created inside of Greater Lawrence Technical School.
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