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INFORI\,TATION AND S IGNATURE FORIV,IFOR STUDENT-ATHLETES & FAR.ENTS/LEGAL GUARDIANS(Actapted tiotu CIIC "I{ead.s Up Concussion tn Yorfh Sports')Public Chapter 148, effective January I, 2014, requires that school and community organizationssponsoring youth athletic activities establish guidelines to infonn and educate coaches, youth athletes andother adulis involved in youth athletics about the nature; risk and symptoms of concussion/head rnjury.Read and keep this page.. Sign aud return the srgratnre Fage.A concussion is a type of traumatic brain injury that changes the way the brain normally works. Aconcussion is caused by a bump, blow or jolt to the head or body that causes the head and brain to moverapidly back'a:rd forth. Even a "ding," "getting your bell rung" or what seems to. be a mild bump or blowto the head can be serious.
WHAT ARE THE SIGNS AND SYMPTOMS OF CONCUSSION?Signs and symptoms of concussion can show up right after the injury or may not appear or.be noticeduntil days or weeks after tle qjury. .If an athlete reports one or more symptoms of concussion listed below after a bump, blow or jolt to thehead or body, i/he should be kept out of play the day of the injury and until a health care provider* saysslhe is symptom-free and it's OKto rehrm to play.
*Hea1h care provider means a Iennessee licensed medical doctor, qsteopathic physician or a clinicalneurepsychologist with concussrbn training
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