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OCDSB 975 Concussion Code of Conduct Parents GuardiansOCDSB 975 - Concussion Code of Conduct for Interschool Sports Parent/Guardian Reference: PR.561.SCO Concussion Management Participation by students in Interschool Sports is dependent on the review and submission of this form by the parent/guardian. Students will be prohibited from participating until this form has been submitted. Student Information Please provide your child/student information (Please use the name used when registering the student at the beginning of the school year) Student First Name: Student Middle Name (if applicable): Student Last Name: Date of Birth: School Name: Grade: Maintaining a safe learning environment •I will encourage my child to bring potential issues related to the safety of equipment and the facilities to the attention of the coach. •I will ensure the protective equipment that we provide is properly fitted as per the manufacturer’s guidelines, in good working order, and suitable for personal use. Fair play and respect for all •I will follow the school board’s fair play policy and will support it by demonstrating respect for all students, coaches, officials, and spectators. •I will encourage my child to demonstrate respect for teammates, opponents, officials, and spectators and to follow the rules of the sport and practice fair play. • I will not pressure my child to participate in practices or games/competitions if they are injured. Teaching/learning the rules of a physical activity, including the strict enforcement of consequences for prohibited play that is considered high-risk for causing concussions • I will encourage my child to learn and follow the rules of the sport and follow the coach’s instructions about prohibited play. • I will support the coach’s enforcement of consequences during practices and competition regarding prohibited play. • I will respect the decisions of officials and the consequences for my child for any prohibited play. Implementing the skills and strategies of an activity in a proper progression • I will encourage my child to follow their coach’s instructions about the proper progression of skills and strategies of the sport. • I will encourage my child to ask questions and seek clarity regarding skills and strategies they of which they are unsure. Providing opportunities to discuss potential issues related to concussions • I will encourage my child to participate in discussions/conversations related to concussions, including signs and symptoms, with the coach or caring adult. • I will encourage my child to talk to their coach/caring adult if they have any concerns about a suspected or diagnosed concussion or about their safety in general. Concussion recognition and reporting • I have read and am familiar with an approved Concussion Awareness Resource identified by the school board [link to awareness resource]. • I understand that if my child receives a jarring impact to the head, face, neck, or elsewhere on the body that is observed by or reported to the coach my child will be removed immediately from the sport, and: o I am aware that if my child has signs or symptoms of a suspected concussion they should be taken to a medical doctor or nurse practitioner for a diagnosis as soon as reasonably possible that day and I will report any results to appropriate school staff. o I am aware that not all signs and symptoms emerge immediately and there are times when signs and symptoms emerge hours or days after the incident and in these cases my child must stop all physical activities and be monitored at home and at school for the next 24 hours. • If no signs or symptoms emerge after 24 hours, I will inform the appropriate school staff and I understand my child will be permitted to resume participation. • If signs or symptoms emerge, I will have my child assessed by a medical doctor or nurse practitioner as soon as reasonably appropriate that day and will report the results to appropriate school staff. • I will inform the school principal, coach and/or other relevant school staff when my child experiences signs or symptoms of a concussion, including when the suspected concussion occurs during participation in a sport outside of the school setting. • I will inform the school principal, coach and/or other relevant school staff any time my child is diagnosed with a concussion by a medical doctor or nurse practitioner. • I will encourage my child to remove themselves from the sport and report to a coach or caring adult if they have signs or symptoms of a suspected concussion. • I will encourage my child to inform the coach or caring adult when they suspect a teammate may have sustained a concussion. Acknowledging the importance of communication between the student, parent, school staff, and any sport organization with which the student has registered • I will share with the coach, school staff, and/or staff supervisor of all sport organizations with which my child has registered if/when my child has experienced a suspected or diagnosed concussion or general safety issues. Supporting the implementation of a Return to School Plan for students with a concussion diagnosis • I understand that if my child has a suspected or diagnosed concussion, they will not return to full participation, including practice or competition, until permitted to do so in accordance with the School Board’s Return to School Plan. • I will ensure my child receives a Medical Clearance as required by the Return to School Plan, prior to returning to full participation in “non-contact sports” or returning to a practice that includes full contact in “contact sports”. Prioritizing a student’s return to learning as part of the Return to School Plan • I will follow the recovery stages and learning strategies proposed by the collaborative team for my child as part of the Return to School Plan. Parent/Guardian Information Parent/Guardian Name: Phone: Email Address: Acknowledgement I have read and understand all information of this code of conduct. Date: The personal information on this form is collected under the authority of the Education Act (R.S.O. 1990 c.E2), and in accordance with the Municipal Freedom of Information and Protection of Privacy Act (RSO. 1990 c.M56), as amended. It will be used for student participation in interschool sports, and for education related purposes such as administration, communication, collection of fees, data reporting, and student transportation services. In addition, the information may be used or disclosed to comply with legislation, for compelling circumstances affecting health and safety, or discipline related to law enforcement matters. It may be shared with third parties in accordance with established service agreements, or in accordance with any other Act. Questions or concerns should be directed to the school principal or the District’s Freedom of Information Coordinator, Ottawa-Carleton District School Board, 133 Greenbank Road, Ottawa, Ontario K2H 6L3, Telephone 613-596-8211. CONFIDENTIAL WHEN COMPLETED. © 2020 Ophea | Ontario Physical Activity Safety Standards in Education