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High Park Club Concussion Code of Conduct for Athletes 18 to 26 years of age

All athletes between 18 to 26 years of age must fully read this document and provide an electronic signature before participating in any of the High Park Club’s Curling Programs.

I will help prevent concussions by:

  • Wearing the proper equipment for my sport and wearing it correctly.
  • Developing my skills and strength so that I can participate to the best of my ability.
  • Respecting the rules of my sport or activity.
  • Respecting the safety rules of the High Park Club.
  • My commitment to fair play and respect for all (respecting other athletes, coaches, team trainers and officials).

I will care for my health and safety by taking concussions seriously, and I understand that:

  • A concussion is a brain injury that can have both short- and long-term effects.
  • A blow to my head, face or neck, or a blow to the body that causes the brain to move around inside the skull may cause a concussion.
  • I don’t need to lose consciousness to have had a concussion.
  • I have a commitment to concussion recognition and reporting, including self-reporting of possible concussion and reporting to a designated person when an individual suspects that another individual may have sustained a concussion.
    • If I think I might have a concussion I should stop participating in further training, practice or competition immediately, or tell an adult if I think another athlete has a concussion.
  • Continuing to participate in further training, practice or competition with a possible concussion increases my risk of more severe, longer lasting symptoms, and increases my risk of other injuries.

I will not hide concussion symptoms. I will speak up for myself and others.

  • I will not hide my symptoms. I will tell a coach, official, team trainer, parent or another adult I trust if I experience any symptoms of concussion.
  • If someone else tells me about concussion symptoms, or I see signs they might have a concussion, I will tell a coach, official, team trainer, parent or another adult I trust so they can help.
  • I understand that if I have a suspected concussion, I will be removed from sport and that I will not be able to return to training, practice or competition until I undergo a medical assessment by a medical doctor or nurse practitioner and have been medically cleared to return to training, practice or competition. 
  • I have a commitment to sharing any pertinent information regarding incidents of removal from sport with the athlete’s school and any other sport organization with which the athlete has registered.
    • If I am diagnosed with a concussion, I understand that letting all of my other coaches and teachers know about my injury will help them support me while I recover.

I will take the time I need to recover, because it is important for my health.

  • I understand my commitment to supporting the return-to-sport process.
  • I will have to follow my sport organization’s Return-to-Sport Protocol.
  • I understand I will have to be medically cleared by a medical doctor or nurse practitioner before returning to training, practice or competition.
  • I will respect my coaches, team trainers, parents, health-care professionals, and medical doctors and nurse practitioners, regarding my health and safety.
  • I will review the Ministry of Sport Concussion Awareness Resource found at Ontario.ca/concussions.
  • I understand that it is my responsibility to review these resources once per year.
  • If you would like to have a record of your review of the concussion awareness resources, you can complete this form and keep it as a receipt to remind you of the date on which you reviewed it.

By providing an electronic signature I acknowledge that I have fully reviewed, understand and commit to this Concussion Code of Conduct and the appropriate Concussion Awareness Resources and commit to operating within the parameters of the High Park Club Concussion Code of Conduct.

 

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First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Parent or Guardian's Email Address

Email*

Confirm Email*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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