Liability Release Form:
For and in consideration of permission to participate in the recreation activity, I the undersigned participant (if over age 18) or parent or guardian (if participant is under 18) completely release and agree to indemnify and hold Puyallup School District and Rogers High School and its employees, its hired or contracted instructors and any other person, volunteers or organizations affiliated with Rogers High School in connection with this recreation activity harmless from and against any and all liability for any injury or damage from negligence or otherwise which may be suffered by the participant arising out of or in any way connected with this recreation activity. I realize that recreation activities have an inherent risk of physical injury. If the participant has any physical ailments or conditions that might affect his/her health by participating in the activity, I have consulted a physician or other medical authority and received permission to participate. If an injury occurs, I agree to use personal insurance to cover all medical expenses.

Photography Release Form:
I hereby grant Rogers Basketball and its legal representatives the irrevocable right and unrestricted permission to use and publish photographs or video images of my minor/s in which pictures may be included, for any purpose authorized by Rogers Basketball, including but not limited to: website use, editorial publications, catalog and advertising use. In granting this permission to Rogers Basketball and its legal representatives, I am fully and without limitation releasing it from any liability that may arise from the use of the images.

Concussion Form:
A concussion is a brain injury and all brain injuries are serious. They are caused by a bump, blow, or jolt to the head, or by a blow to another part of the body with the force transmitted to the head. The can range from mild too severe and can disrupt the way the brain normally works. Even though most concussions are mild, all concussions are potentially serious and may result in complications including prolonged brain damage and death if not recognized and managed properly. In other words, even a “ding” or a bump on the head can be serious. You can’t see a concussion and most sports concussions occur without loss of consciousness. Signs and symptoms of concussion may show up right after the injury or can take hours or days to fully appear. If your child reports any symptoms of concussion, or if you notice the symptoms or signs of concussion yourself, seek medial attention right away.

Symptoms may include one or more of the following:
Headaches “Don’t feel right” “pressure in head”
Nausea or vomiting Sadness Fatigue or low energy
Neck pain Nervousness or anxiety Balance problems or dizziness
Irritability More emotional Blurred, double or fuzzy vision
Confusion Drowsiness Sensitivity to light or noise
Amnesia Change of sleep patterns Concentration or memory problems
Feeling foggy or groggy Feeling sluggish or slowed down Repeating the same question/comment

Signs observed by teammates, parents and coaches include:
Appears dazed Vacant facial expression Shows behavior or personality changes
Confused about assignment Can’t recall events prior to hit Can’t recall events after hit
Forgets plays Seizures or convulsions Loses consciousness
Slurred speech Answers questions slowly Moves clumsily or displays in coordination
Is unsure of game, score or opponent Any change in typical behavior or personality

What can happen if my child keeps on playing with a concussion or returns too soon?
Athletes with the signs and symptoms of concussion should be removed from play immediately. Continuing t play with the signs and symptoms of a concussion leaves the young athlete especially vulnerable to greater injury. There is an increased risk of significant damage from a concussion for a period of time after that concussion occurs, particularly if the athlete suffers another concussion before completely recovering from the first one. This can lead to prolonged recovery, or even to severe brain swelling (second impact syndrome) with devastating and even fatal consequences. It is well known that adolescent or teenage athletes will often under report symptoms of injuries. And concussions are no different. As a result, education of coaches, parents and students is the key for an athlete’s safety.

What to do if you think your child has summered a concussion:
Any athlete even suspected of suffering a concussion should be removed from the game or practice immediately. No athlete may return to activity after an apparent head injury or concussion, regardless of how mild it seems or how quickly symptoms clear, without medical clearance. Close observation of the athlete should continue for several hours. You should also inform your child’s coach if you think that your child may have a concussion. Remember that it is better to miss one game than miss the whole season. And when in doubt, the athlete sits out. For current and up to date information on concussion you can go to: www.cdc.gov/concussionsinyouthsports/

SUDDEN CARDIAC ARREST INFORMATION

What is sudden cardiac arrest? Sudden Cardiac Arrest (SCA) is the sudden onset of an abnormal and lethal heart rhythm, causing the heart to stop beating and the individual to collapse. SCA is the leading cause of death in the U.S. afflicting over 300,000 individuals per year. SCA is also the leading cause of sudden death in young athletes during sports

What causes sudden cardiac arrest? SCA in young athletes is usually caused by a structural or electrical disorder of the heart. Many of these conditions are inherited (genetic) and can develop as an adolescent or young adult. SCA is more likely during exercise or physical activity, placing student-athletes with undiagnosed heart conditions at greater risk. SCA also can occur from a direct blow to the chest by a firm projectile (baseball, softball, lacrosse ball, or hockey puck) or by chest contact from another player (called “commotio cordis”).

Warning Signs

While a heart condition may have no warning signs, some young athletes may have symptoms but neglect to tell an adult. If any of the following symptoms are present, a cardiac evaluation by a physician is recommended:

· Passing out during exercise
· Chest pain with exercise
· Excessive shortness of breath with exercise
· Palpitations (heart racing for no reason)
· Unexplained seizures
· A family member with early onset heart disease or sudden death from a heart condition before the age of 40

How to prevent and treat sudden cardiac arrest (SCA)? Some heart conditions at risk for SCA can be detected by a thorough heart screening evaluation. However, all schools and teams should be prepared to respond to a cardiac emergency. Young athletes who suffer SCA are collapsed and unresponsive and may appear to have brief seizure-like activity or abnormal breathing (gasping). SCA can be effectively treated by immediate recognition, prompt CPR, and quick access to a defibrillator (AED). AEDs are safe, portable devices that read and analyze the heart rhythm and provide an electric shock (if necessary) to restore a normal heart rhythm.

For further information on SCA:
http://us10.campaign-archive2.com/?u=fe2496ab0bb9900b8ccdc7730&id=226b151cc1

Please initial your agreement of the Rams Hoops Uniform Policy. All loaned/rented uniform items must be returned undamaged as issued- unaltered (minus normal wear and tear), and available to use for future players. Cost for altered or lost equipment must be paid for by the parent. We reserve the right to seek compensation for all uniforms not returned within 30 days of your child's team’s last contest/practice by filing for payment in small claims court.

By initialing below, you are agreeing to all the terms and conditions above.