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Coach or other removes student from activity and completes form and gives to student or parent. Included medical release must be obtained before student can return to play.  Optional to use for other serious injuries.

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Effective January 1, 2012, a new law ( Education Code Section 49475), requires the student and parent/legal guardian must sign this Concussion Head Injury Information Sheet before a Student may try-out, practice, or compete in any District-sponsored extracurricular athletic program, including interscholastic, intramural, or other sport or recreation programs (including cheer/dance teams and band), but excluding physical education courses for credit.  

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