Your child will bring you the following form:

Parent-Guardian Declaration & Permission to Play Form

This is a very important document and must be returned by your child before he is permitted to take part in any activity with the school team. This form is to be completed for every team and/or activity designated by the school as including the risk of concussion injury.

PERMISSION STATEMENTS::

1. First of all, you will be giving your child permission to participate in the sport or activity.
    
2. If your child has not already been given an ImPACT Baseline test within the previous two years, you will also be giving your child permission to take part in an ImPACT test.
     

   BASELINE NEUROCOGNITIVE EVALUATION  OF STUDENT-ATHLETES   1.   ImPACT is a computer-based battery of tests developed specifically for assessing sport-related concussion. The computer program measures multiple aspects of cognitive functioning, including attention span, working memory, sustained and selective attention time, response variability, and several facets of verbal/visual memory. This will register a “baseline” record of their abilities of the student-athlete with which to test against should they suffer some form of brain injury during the season.   2.   Mandatory Baseline ImPACT testing required for all student-athletes before they participate in designated contact sports;   3.   ImPACT testing will be available for up to 600 student-athletes per school;   4.   Assessment of baseline testing supervised by licensed Neuropsychologist with experience in concussion management . 5.    For information about the ImPACT test, click here>>>

   This permission will allow the School CMP Head Coach to give your child the ImPACT test if and when it is determined that he/she is required to take such test in order to become qualified to participate in the sporting activity, and/or if he/she has been injured and it is necessary for him/her to take such a test to determine the extent of brain dysfunction as a result of an injury. This test is critical to the success of our program and as such all student-athletes who participate on school teams must have one.
    

3. You will also be giving your child permission to take part in a CMP Concussion Management Certification Course if and when it is determined that he/she is required to take part in such a course. Your child will only be required to take part in the course once during his/her time in secondary school. However, your child will be required to comply with the Continuing Education compliance protocols to remain qualified. 

PARENT/GUARDIAN DECLARATION STATEMENTS

1. The first and most important thing you will be declaring is that as of the date you signed the form your child does not exhibit and/or admit to any of the signs or symptoms that would be associated with having a concussion. You must not knowingly put your child in danger if you are aware that he/she may be suffering from the effects of a concussion.
    
2. You will also be declaring that you are fully aware of the CMP Student-Athlete Concussion Management Program and that you agree to support and abide by all of the procedures and protocols that are part of the program and which are available on this company web site.
    
3. You will be stating that you are aware of and agree that your child will immediately be removed from competition if it is suspected that he/she may have suffered a concussion;
    
4. You will agree that once removed from play, it will be your responsibility as his/her parent/guardian to bring your child to a physician for examination to determine if there are any injuries that would prevent him/her from returning to physical activities;
    
5. You are accepting responsibility for making sure that the necessary Clearance forms are completed and signed if your child  is injured. Those forms can be found in the following  Injury Package.
    
6. You are declaring that you will accept the fact that your child will not be permitted to take part in any activities of a physical nature, either at school or elsewhere, while under a rehab program for concussion. There are certain protocols that we will be following to help your child deal with a concussion injury, and it is imperative that he/she follow the protocol without endangering him/herself in outside school activities. Therefore, since your child is under your care outside of school, it is critical to our program that you support the protocols. It wouldn't do much good for a child to be prevented from playing hockey for his/her school team but still be playing for his minor sport club.
    
7. We will be doing what we can to advise your child's classroom teachers about his/her injury, but under an abundance of caution, we would also like you to declare that you will be responsible for informing your child's teachers about the nature of his/her injury and the need to adjust his/her school activities and expectations. We have provided you with a form for this purpose in the Injury Package.
    
8. Perhaps the most important declaration on your part will be your agreement to monitor the progress of your child at home and that you will only sign the Parent/Guardian Clearance to Return to Physical Training if you are certain that you have not seen any signs or symptoms of concussion for as long a period that satisfies you he/she has recovered. We feel that despite all of the training that doctors, teachers and coaches may have, there is no one who knows your child better than you. You see your child at home. You know whether your child's sleep patterns, behaviour patterns, emotional stability, and general approach to life is the same as it was before the injury. You are the best one to determine whether or not your child is ready to get back to physical training designed to return him/her to competition. Nothing happens until your child's School CMP Head Coach receives your clearance.
    
9. Please go to the following link to review the signs and symptoms of a concussion and be clear about the challenges that exist when it comes to identifying a concussion. This is an extremely important section of this web site and it will help you to better understand your role as a parent/guardian.

IN CASE OF INJURY:

If your child suffers an injury that in the opinion of one or more of his/her coaches, the School CMP Leader, yourself, or your child, may have caused enough of a brain trauma to possibly result in a concussion, we will immediately put into effect the CMP Student-Athlete Concussion Management Program. 

This means that you will take care of the following as your part in the program:

1. You will receive the Injury Package and a copy of the SCAT2 evaluation from a School CMP Coach. This should be given to you immediately after the SCAT2 evaluation has been done on the sidelines or in the dressing room. However, if you were not at the game, you will get the information package when your child comes home. Because of the nature of brain injuries, you may be required to come to the site to pick up your child. Our coaches are extremely wary about leaving a child on his/her own following a suspected brain injury. I'm sure you understand our concern for your child.
    
2. Whether you bring your child to the emergency department that night or wait for the next day to bring him/her to your family doctor will depend on the nature and extent of the injury. We want to make sure that there is no physical damage such as a fracture to the skull or neck area, and we want to rule out the possibility of internal bleeding from the rupture of a blood vessel. The urgency of that visit will be something that you as a parent/guardian will have to determine based on all of the information you are provided after the incident.
   
   NOTE: If your child's symptoms increase in severity, do not hesitate to bring him/her to the emergency room that first evening. Use your intuition as a parent. If you feel your child is getting worse, then take him/her for a check up. It is better to be sure that there are no complications. 
    
3. Once you bring your child back home, it is important for you to remember that whereas the brain may continue to deteriorate following an injury, and since the conditions in and around the brain after an injury are not all that conducive to healing, it is absolutely imperative that we reduce as much as possible any unnecessary activity that will cause the brain cells to experience any form of stress, no matter how trivial it may seem. Therefore, it is up to you to make sure that your child gets total physical and mental rest immediately following an injury.
    
   This means that when your child returns home following the injury, even if he/she has seen a doctor immediately after the game, there is to be no television at all at home that day. The visual stress of watching a television program may strain the injured areas of the brain. Therefore, this is not a time to come home, sit on the couch and watch television.
    
   There is to be no "radio" or "music from MP3 players" for at least the first night or until the symptoms disappear. If the music brings back symptoms, then this activity must cease.
    
   Your child should not be allowed to use the computer to play video games or for any other purpose. Forget about doing homework or assignments immediately after an injury. Teachers will understand.
    
   There is to be no use of cell phones or sending or receiving text messages. Take the phone away so there is no temptation. Nor are there to be any phone calls.
    
   You should also make sure your child refrains from doing any reading, whether they are books or magazines.
    
   Finally, keep conversations to a minimum. Your child should go to bed in a dark, quiet room and just rest. This is a time to completely shut down the brain and let the body heal itself.
     
4. You must be prepared to explain to your child that even though he/she may not be feeling any symptoms from the injury, and this may even be the case by the time you return home from the game, this doesn't mean the concussion has healed. The headaches, dizziness, vision concerns and feeling that something is wrong, will disappear if the stress causing the problems disappears. However, that does not mean that the healing is completed. It just means that as long as you reduce the stress on the brain, the symptoms will be reduced. Unfortunately, too many young people think that as soon as symptoms disappear they are ready to get back to normal. Nothing could be further from the truth. This is an injury that takes time and both physical and cognitive rest to heal.
    
5. In most cases the day after the injury should also be a day of rest. You may want to keep your child home from school that day if some of the symptoms still prevail.  If the symptoms have gone away, you can consider allowing your child to get up and walk around slowly for a while. You might allow a few minutes of watching television. You may even allow some music if the volume is low (not with an earphone). The strategy here is to keep everything at the absolute minimum and to be carefully monitoring which activities cause symptoms to return. As soon as a symptom returns you must make sure your child ceases whatever activity was causing the problem.
    
6. You will contact the School CMP Leader and make arrangements to bring your child in for a post-injury ImPACT test. This should be done 24 to 72 hours following the injury. Your School CMP Leader will set up a time when your child can be brought in to do the test.
    
7. You should then fill out the information on the Notification To Teachers that is part of the Injury Package and make enough copies for your child to bring to his/her teachers. Depending on the speed of recovery of your child, you may want to implement a gradual return to class where he/she attends for half-days for a few days. This will all be decided in collaboration with your child's teachers, your child and yourself.
    
8. In the days that follow the injury, you should carefully observe your child for any abnormalities in behaviour. Your child may not notice the changes, but you should. You should especially notice if there is any change in sleep patterns, emotional stability, depression, etc. All of these are common with brain injuries.
    
9. Allow your child to gradually increase the amount of time doing normal activities, even encouraging a bit of light walking, but do not allow weight lifting, jogging or anything else that will cause movement in the brain or resistance to the muscles. As long as the increased activity does not bring on symptoms, you can allow the progression to continue. In fact, low level activity has been shown to be helpful since it tends to elevate the mood and reduce the stress that may be felt by the student-athlete. It may also help the student sleep.
    
10. Once the signs and symptoms have disappeared and you are confident that it seems as if the injury is well on its way to healing, you may sign the Parent-Guardian Clearance to Resume Physical Training. When you are ready to sign that form, we would suggest that you also sit down with your child and examine the Student-Athlete Clearance to Resume Physical Training form. That way, both you and your child can discuss the recovery that has taken place and you can be even more satisfied that he can proceed with the next steps. Ask your child some tough questions. This is not a time to be hiding symptoms in order to get back into competition. The rest of his/her life may depend on this decision.
     
11. Once your child is cleared to begin Physical Training, your job as parent/guardian is still not finished. You should be observing your child for signs that the symptoms may be returning. If you feel that symptoms are returning, it is critical that you tell your child that it is time to slow down the training and that you will inform his coach. Keep in mind that a concussion injury is a process, it is not an event. Also, we are not completely sure about the extent of the damage that has been caused, so the only way we can tell if the rehabilitation is successful is by observing to see if there is any return of symptoms while we are gradually increasing physical and cognitive exertion. Once we go too far, we must pull back or risk causing even more damage than we had with the original injury.
     
12. Eventually, your child will be able to return to competition. Our goal is to make sure that when he/she does finally return to play, the risk of a second concussion will be greatly reduced. If anything, the CMP Student-Athlete Concussion Management Program is designed to "delay" the return to play longer than may be necessary, just to make sure.
     
13. Of course, you should be making regular contact with your child's classroom teachers to see what kind of progress he/she is making at school. This return to the classroom process is just as critical to the successful rehabilitation of your son/daughter.
     
14. If you ever have any questions, please make sure you contact your School CMP Leader or you can contact us here at CMP Concussion Management Partners Inc. by emailing:
     
    robertkirwan@concussionmanagementpartners.com 
     
    or phoning me at (705) 969-7215