Rowans Law (Tillsonburg Minor Hockey Inc.)

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Demographics

Player's First Name^*
Player's Last Name^*
Parent(s) Name^*
Email Address^*

Example: [email protected] Your submission will be sent to this address.

Date^*

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Registered Team

Which division is your child registered in ^*
Novice
Atom
Pee Wee
Bantam
Midget
Beginner
Initiation (Jr Tyke)
Minor Novice
Volunteer
Please select one

Parent/Guardian: I acknowledge that I have fully reviewed and commit to this Concussion Code of Conduct.^*

Acknowledgement of Review

Concussion Awareness Resource consists of Concussion Code of Conduct (included in document); Removal from Play; Return to Play (included in document); age appropriate concussion material (in Concussion Awareness Sheet team home page library) and links to resources (in Concussion Awareness Sheet in team home page library)

I confirm that I have reviewed the Ontario Ministry/OWHA/OMHA Concussion Awareness Resource, including the age appropriate appendix and commit to operating within its parameters.

Player's Name if older than 18

Date

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I confirm that I have reviewed the Ontario Ministry/OWHA/OMHA Concussion Awareness Resource, including the age appropriate appendix and commit to operating within its parameters.

Name of Parent if above signatory is under 18 years of age