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HomeMy WebLinkAboutOCDSB 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.
Submission of this form is required once per school year.
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:
Ministry-approved Awareness Resources. Please confirm you have read one of the
following resources:
Ages 10 and Under
Ages 11-14
Ages 15 and Up
•
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 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.
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 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.
Concussion recognition and reporting
•I have read and am familiar with an approved Concussion 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:
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.
•
•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.
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.
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”.
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
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:
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