WALLKILL VALLEY REGIONAL HIGH SCHOOL
ATHLETIC DEPARTMENT
"HOME OF THE RANGERS"

Daryl Jones- Director of Athletics

 

 

NJSIAA Parent/Guardian Acknowledgment Form

In order to help protect the student athletes of New Jersey, the NJSIAA has mandated that all athletes, parents/guardians, and coaches follow the NJSIAA Concussion Policy.

A concussion is a brain injury and all brain injuries are serious. They are caused by a bump, blow, or jolt to the head, or by blow to another part of the body with force transmitted to the head. They can range from mild to severe and can disrupt the way the brain normally works. Even though most concussions are mild,  all concussions are potentially serious and may result in complications including prolonged brain damage and death if not recognized and managed properly. In other words, even a "ding" or bump on the head can be serious. You can't see a concussion and most sports concussions occur without loss of consciousness. Signs and symptoms of concussions may show up immediately after the injury or can take hours to fully appear. If your child/player reports any symptoms of concussion, or if you notice the symptoms or signs of concussion yourself, seek medical attention right away.

Symptoms may include one or more of the following:

  1. Headache
  2. Nausea/vomiting
  3. balance problems or dizziness
  4. double vision or changes in vision
  5. sensitivity to light or sound/noise
  6. Feeling of sluggishness or fogginess
  7. difficulty with concentration, short-term memory, and/or confusion.
  8. irritability or agitation
  9. Depression or anxiety
  10. Sleep disturbance

Signs observed by teammates, parents and coaches include

  1. Appears dazed, stunned, or disoriented
  2. Forgets plays or demonstrates short-term memory difficulties(e.g. is unsure of the game, score, opponent)
  3. Exhibits difficulties with balance or coordination
  4. Answer questions slowly or inaccurately
  5. Loses consciousness
  6. Demonstrates behavior or personality changes.
  7. is unable to recall events prior to or after the hit

What can happen if my child/player keeps on playing with a concussion or returns too soon?

Athletes with the signs and symptoms of concussion should be removed from play immediately. Continuing to play with the signs and symptoms of a concussion leaves the young athlete especially vulnerable to greater injury. There is an increased risk of significant damage from a concussion for a period of time after the concussion occurs, particularly if the athlete suffers another concussion before completely recovering from the first one. The can lead to prolonged recovery, or even severe brain swelling (second impact syndrome)with devastating and even fatal consequences are no different. As a result, education of administrators, coaches, parents, and students is the key for the student athletes safety.

If you think you child/player has suffered a concussion

Any athlete even suspected of suffering a concussion should be removed from the game or practice immediately. No athlete may return to activity after an apparent head injury or concussion, regardless of how mild it seems or how quickly symptoms clear. Close observation of the athlete should continue for several hours. An athlete who is suspected of sustaining a concussion or head injury in a practice or game shall be removed from return to play until the athlete is evaluated by a medical doctor or doctor of Osteopathy, trained in evaluation and management of concussions and received written clearance to return to play from health care provider.

You should also inform your child's Coach, Athletic Trainer(ATC), and/or Athletic Director, if you think your child/player may have a concussion. And when it doubt, the athlete sits out. For current and up-to-date information on concussions go to:

http://www.cdc.gov/concussion/HeadsUp/youth.html

http://www.nfhslearn.com/

ImPact Concussion Management Testing Program

Wallkill Valley Regional High School is implementing a new program for all our students-athletes. In order to better manage concussions sustained by our student-athletes, we will be using the ImPact(Immediate Post Concussion Assessment and Cognitive Testing) Program. This 35 minute computerized exam will be administered to all athletes prior to start of their season. Also, this web-based program is completely confidential and password protected. You may learn more about the test by visiting the website: www.impacttest.com.

All athletes will be required to take the test in order to participate in any athletic program. The results will be used to evaluate your child's progress should they experience a concussion. By signing this form you are acknowledging that you have read the preceding information. All forms must be returned to the athletic office prior to the first practice.

_________________________    _________________________     _________

Signature of Student-Athlete            Print Student-Athlete's Name             Date

________________________   __________________________    __________

Signature of Parent/Guardian          Print parent/Guardian's Name              Date

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