Rowans Law (Tillsonburg Minor Hockey Inc.)

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^*

Registered Team

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

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

Date

Rowans Law (Tillsonburg Minor Hockey Inc.)

OMHA Digital Network

Demographics

Registered Team

Acknowledgement of Review

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