Completion of this form indicates that North Palm Beach Rowing Club, as an “Independent Sanctioning Authority,” has completed background screening of all athletic coaches and volunteers who will regularly interact with youth athletes. This “Independent Sanctioning Authority” has not allowed any athletic coach to participate without a background screening on file with Palm Beach County Parks and Recreation.

Our organization has adopted guidelines to educate athletic coaches, officials, administrators, and youth athletes and their parents and/or guardians of the nature and risk of concussion and head injury.

Our organization has adopted written policies that require the parent or guardian of a youth who is participating in athletic competition or who is a candidate for an athletic team to sign and return an informed consent that explains the nature and risk of concussion and head injury, including the risk of continuing to row after concussion or head injury, each year before participating in athletic competition or engaging in any practice, tryout, workout, or other physical activity associated with the youth’s candidacy for an athletic team.

Our organization has adopted a policy requiring each youth athlete who is suspected of sustaining a concussion or head injury in a practice or competition to be immediately removed from the activity. A youth athlete who has been removed from an activity may not return to practice or competition until the youth submits to the athletic coach a written medical clearance to return stating that the youth athlete no longer exhibits signs, symptoms, or behaviors consistent with a concussion or other head injury. Medical clearance must be authorized by the appropriate health care practitioner trained in the diagnosis, evaluation and management of concussions as defined by the Sports Medicine Advisory Committee of the Florida High School Athletic Association.

A copy of the policy (an appendix to the NPBRC Safety and Operations Manual) and a record of background screened adults assisting the youth team this season are posted on Team App under the “documents” tab. North Palm Beach Rowing Club has verified that the items listed above are in accordance with Florida State Statute 943.0438.

Informed Consent - Concussion

"*" indicates required fields

Name of Minor (Athlete)*
As a parent or guardian, I have read and understand this consent form and I give permission for my child, named above, to participate.
Name of Parent of Guardian*