Acknowledgment of Concussion Information Sheet
Please read over the Concussion Information Sheet by clicking on the link below, and then complete the survey. The Concussion Information Sheet must be read by a parent/guardian and then reviewed with the player. Your completion of this survey acknowledges that TVYSC has shared information with you about Concussions, Symptoms and what should be done if you suspect, or a coach suspects your player may have a concussion. If a player experiences a possible concussion during practice or a game; they will not be allowed to participate again until they have been evaluated by their healthcare provider.
Player's First Name (If you have more than one child you will have to do one for each child.)
Player's Last Name (If you have more than one child you will have to do one for each child.)
Please select the Head Coach/Level for the above player. Only one choice-if your player is a double roster please select the team that matches the grade they are entering this year.
Pre-K: Nick Hoffman
Kindergarten: Katie Burian
1st & 2nd Grade: Nikki Stankus
3rd Grade Girls: Ashley Klinger
3rd Grade Boys: Darren Gates
4th Grade Girls: Melissa Hoffman-Long
4th Grade Boys: Amanda Kaine
5th/6th Grade Girls: Scott Ballay
5th/6th Grade Girls: Denny Grimm
5th/6th Grade Boys: Ben Hillard
7th/8th Grade Girls: Jonathan Tolar
7th/8th Grade Boys: Mike Begis
Your First and Last Name
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service