I am signing this Acknowledgment of Risk/Concussion Awareness form as a condition to my child’s participation in Flathead Valley Little Guy Football (hereinafter “FVF”). My signature on this document represents my express acknowledgment and understanding that the activity of full contact football, like all sports, involves certain risks of injury, damage and/or harm. I acknowledge that, despite reasonable efforts to avoid injury, damage, or harm and the use of protective equipment, my child may be injured, damaged or harmed during participation in all FVF activities. I (and my child’s other parent or legal guardian if applicable) am voluntarily allowing my child to participate in FVF football with a full understanding of and acceptance of these risks of injury, damage or harm.
I acknowledge and accept my personal responsibility to advise myself of the risks of my child’s participation in FVF football and my child’s responsibility to act reasonably and appropriately during my child’s participation in FVF football. I agree to comply with all rules, regulations and requirements of FVF football and I also agree to advise my child of those rules, regulations and requirements and take reasonable steps to ensure my child complies with the FVF football rules, regulations and requirements. We further acknowledge and agree we will follow and abide by all FVF final decisions regarding player, parent, and coaching participation in all FVF activities.
CONCUSSION - I further acknowledge FVF has adopted a Policy/Guideline regarding concussion awareness and return to play following a concussion. I agree to make myself and my child aware of the signs and symptoms of a concussion. In that regard, I agree that I will review the following web sites and information contained therein:
1)
https://www.logan.org/health/services/save-the-brain;
2)
https://www.mhsa.org/sportsmed; and
3)
www.flatheadvalleyfootball.com.
I further specifically agree to watch and make my participant child watch the concussion awareness video contained at
https://www.krh.org/krmc/services/neuroscience-and-spine/save-the-brain.
I understand these web sites contain important information regarding the signs and symptoms of concussion. I agree to report immediately any signs or symptoms of potential concussion experienced by my child or another child participating in FVF football. I will report directly to my child’s coach and a FVF football board member. I further understand that my child will be withheld from participation if he/she is suspected to have a concussion. Once a concussion is confirmed, I agree my child will not return to any FVF football activity until he/she is cleared by an authorized medical provider as well as a FVF football board member and has fully complied with the FVF football return to play procedures.
In signing this Acknowledgment of Risk/Concussion Awareness form, I am not relying on any oral representation or statements made by representatives of FVF football or any of it’s employees, board members, officers, volunteers, agents or representatives.