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Check here if you have read and agree to the TERMS OF SERVICE.

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Additional Questions

1. I give permission for the children listed in my family profile, as each child’s parent or guardian, to attend and participate in athletic activities sponsored by the Traverse City Bulldog Athletic Association. I understand that these activities require physical activity.

I understand this permission is for this school calendar year and covers all sports my family participates in. (1 required) I HEREBY GIVE MY CONSENT
2. PARENT AUTHORIZATION, ATHLETIC WAIVER & RELEASE

For Competitive Athletic Activities

WARNING STATEMENT TO STUDENTS AND PARENTS

Serious, Catastrophic, and Perhaps Fatal Injury May Result from Athletic Participation

By its nature, competitive athletics may put students in situations where serious, catastrophic, and perhaps fatal accidents may occur.

Many forms of athletic competition result in violent physical contact among players, the use of sports equipment that may result in accidents, strenuous physical exertion, and numerous other exposures of risk of injury.

Students and parents must assess the risks involved in such participation and make their choice to participate in spite of those risks. No amount of instruction, precaution, or supervision will totally eliminate all risk of injury. Just as driving an automobile involves a choice of risk, athletic participation may also be inherently dangerous. The obligation of parents and students in making this choice to participate cannot be overstated. There have been accidents resulting in death, paraplegia, quadriplegia, and other very serious physical impairment as a result of athletic competition.

The risk assumed includes injury resulting from the negligence of other student-athletes and participants, and the TCBAA supervision of its athletic program cannot prevent negligent conduct by all participants at all times.

By granting permission for your student to participate in athletic competition, you, the parent or guardian, acknowledge that such risk exists.

Students will be instructed in proper techniques to be used in athletic competition and in the proper utilization of all equipment worn or used in practice and competition. Students must adhere to that instruction and utilization and refrain from improper uses and techniques.

The students are responsible for immediately informing the coach or other supervising TCBAA personnel of any physical or medical condition that might affect the safety of their participation in the athletic program.

ATHLETIC CONSENT AND WAIVER OF LIABILITY

I, the parent or legal guardian, have read the Warning Statement to Students and Parents. I understand that these risks are present in any and all sports. With full knowledge of the warning statement, I am giving my permission and consent for my child or children to participate in all sports offered by the Athletic program of the Traverse City Bulldog Athletic Association.

I agree to release Traverse City Bulldog Athletic Association, its officials, directors, employees, and coaching staff from any and all liability arising out of my child or children’s participation in the athletic program, including liability for injuries caused by the negligent conduct of any persons involved in the program.

MEDICAL AUTHORIZATION AND WAIVER OF LIABILITY

I, the parent or legal guardian, understand that by their nature, competitive athletics may put students in situations in which serious, catastrophic, and perhaps fatal accidents may occur. In the event, my son or daughter is injured. I give authorization to my child or children’s coach or appropriate TCBAA official to render first aid and/or secure medical treatment for him/her to receive whatever treatment is necessary should he/she have to go to a hospital emergency room.

I agree to release Traverse City Bulldog Athletic Association, its officials, directors, employees, coaching staff, and medical staff from any liability arising from first aid rendered and/or medical treatment secured for an injury related to my son or daughter’s participation in the athletic program.
(1 required) I HAVE READ AND AGREE TO ALL OF THE ABOVE
I HAVE READ AND AGREE BUT PLEASE SEE NOTES BELOW
3. AD please note: 4. MEDICAL STATEMENT AND WAIVER OF CLAIM

As a condition to and in consideration of the acceptance of this registration entry, I, the undersigned Parent/Guardian, assume complete responsibility for the children in my family's profile during their participation in the stated Traverse City Bulldogs athletic team.

I understand that I will be notified immediately in a medical emergency. If the coach or his/her representative is unable to contact me, the coach and/or his/her representative may take such temporary measures as deemed appropriate for the welfare of my son/daughter, including but not limited to medical, surgical, and hospital services. I assume complete responsibility for any injury or accident which may occur during or arising from my child’s participation in the Traverse City Bulldogs. I hereby release, waive, indemnify, and hold harmless the sponsors, coaches, drivers, owners of facilities where games/practices take place, and all other persons and entities associated with the Traverse City Bulldogs from any and all injury, loss, and/or damage to my child. In the event of injury or illness, I will be completely responsible for any and all treatment costs.
(1 required) I AGREE TO THE STATEMENT
I HAVE READ AND AGREE BUT PLEASE SEE NOTES BELOW
5. AD please note: 6. Name of Family Doctor 7. Doctor’s Phone Number 8. Insurance Company 9. Policy or Contract Number 10. Group Number 11. Service Code 12. Name of Policy Holder 13. PHOTO RELEASE FORM

I hereby grant the Traverse City Bulldogs Athletic Association permission to use my likeness in a photograph in any and all of its publications, including, but not limited to, websites, promotional materials, yearbooks, and all Association publications, without payment or any other consideration.

I understand that any such materials will become the property of the Traverse City Bulldogs Athletic Association and will not be returned.

I hereby irrevocably authorize the Traverse City Bulldogs Athletic Association to edit, alter, copy, exhibit, publish, or distribute my photograph(s) for publicizing or chronicling the Association’s activities or any other lawful purpose.

I waive the right to inspect or approve any finished product, including written or electronic copy, wherein my likeness appears. I waive any right to royalties or compensation arising from or related to the use of the photograph(s).

I hereby hold harmless, release and forever discharge the Traverse City Bulldogs Athletic Association from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on behalf of myself or my estate, may have because of this authorization.
(1 required) PHOTO RELEASE GRANTED
DECLINE PHOTO RELEASE
14. TRANSPORTATION AUTHORIZATION, WAIVER, AND RELEASE

I give permission for the children listed in my family's profile, as each child's parent or guardian, to travel to and from the athletic activities sponsored by the Traverse City Bulldog Athletic Association. Any driver under the age of 21 shall abide by the attached Michigan Graduated Driver License Level 2 restrictions. I understand that the driver is not an employee of the TCBAA and is not acting as an agent of or on behalf of TCBAA.

WARNING STATEMENT TO STUDENTS AND PARENTS

Serious, Catastrophic, and Perhaps Fatal Injury May Result from Motor Vehicle Transportation

I recognize that by participating in this activity, as well as with any activity involving motor vehicle transportation, my child may risk personal injury or permanent loss. I hereby attest and verify that I have been advised of the potential risks and that I have full knowledge of the risks involved in this activity. By granting permission for my child to be transported to a TCBAA event, I acknowledge that such risks exist.

CONSENT AND WAIVER OF LIABILITY

I, the parent or legal guardian, have read the Warning Statement to Students and Parents. I understand and agree that it is my choice for how my child is to be transported to and from the athletic activities sponsored by the TCBAA. I fully understand that TCBAA is in no way responsible for, nor does TCBAA assume liability for, any injuries or losses resulting from this transportation. I understand that I may choose to allow my child to drive him/herself, be transported by another licensed driver, or make other arrangements for my child to be transported.

I hereby release Traverse City Bulldog Athletic Association, its directors, employees, and coaching staff from any and all liability arising out of my child's transportation to and from athletic activities sponsored by TCBAA, including liability for injuries caused by the negligent conduct of any drivers.
(1 required) I HAVE READ AND AGREE TO ALL OF THE ABOVE
15.

Educational Material for Parents and Students (Content Meets MDCH Requirements)

Sources: Michigan Department of Community Health. CDC and the National Operating Committee on Standards for Athletic Equipment (NOCSAE)

UNDERSTANDING CONCUSSION

Some Common Symptoms

Headache   Balance Problems Sensitive to Noise

Sleep Problems “Feeling Down”   Pressure in the Head

Double Vision Sluggishness Poor Concentration

Not “Feeling Right” Nausea/Vomiting Blurry Vision

Haziness Memory Problems    Feeling Irritable

Dizziness Sensitive to Light   Fogginess

Confusion Slow Reaction Time    Grogginess

WHAT IS A CONCUSSION?

A concussion is a type of traumatic brain injury that changes the way the brain normally works. A concussion is caused by a fall, bump, blow, or jolt to the head or body that causes the head and brain to move quickly back and forth. A concussion can be caused by a shaking, spinning or a sudden stopping and starting of the head. Even a “ding,” “getting your bell rung,” or what seems to be a mild bump or blow to the head can be serious. A concussion can happen even if you haven’t been knocked out.

You can’t see a concussion. Signs and symptoms of concussions can show up right after the injury or may not appear or be noticed until days or weeks after the injury. If the student reports any symptoms of a concussion, or if you notice symptoms yourself, seek medical attention right away. A student who may have had a concussion should not return to play on the day of the injury and until a health care professional says they are okay to return to play.

IF YOU SUSPECT A CONCUSSION:

1. SEEK MEDICAL ATTENTION RIGHT AWAY – A healthcare professional will be able to decide how serious the concussion is and when it is safe for the student to return to regular activities, including sports. Don’t hide it; report it. Ignoring symptoms and trying to “tough it out” often makes it worse.

2. KEEP YOUR STUDENT OUT OF PLAY – Concussions take time to heal. Don’t let the student return to play the day of injury and until a health care professional says it’s okay. A student who returns to play too soon while the brain is still healing risks a greater chance of having a second concussion. Young children and teens are more likely to get a concussion and take longer to recover than adults. Repeat or second concussions increase the time it takes to recover and can be very serious. They can cause permanent brain damage, affecting the student for a lifetime. They can be fatal. It is better to miss one game than the whole season.

3. TELL THE SCHOOL ABOUT ANY PREVIOUS CONCUSSION – Schools should know if a student had a previous concussion. A student’s school may not know about a concussion received in another sport or activity unless you notify them.

SIGNS OBSERVED BY PARENTS:

Appears dazed or stunned
Is confused about assignment or position
Forgets an instruction
Can’t recall events prior to or after a hit or fall
Is unsure of game, score, or opponent
Moves clumsily
Answers questions slowly
Loses consciousness (even briefly)
Shows mood, behavior, or personality changes

CONCUSSION DANGER SIGNS:

In rare cases, a dangerous blood clot may form on the brain in a person with a concussion and crowd the brain against the skull. A student should receive immediate medical attention if, after a bump, blow, or jolt to the head or body, s/he exhibits any of the following danger signs:

One pupil larger than the other
Is drowsy or cannot be awakened
A headache that gets worse
Weakness, numbness, or decreased coordination
Repeated vomiting or nausea
Slurred speech
Convulsions or seizures
Cannot recognize people/places
Becomes increasingly confused, restless or agitated
Has unusual behavior
Loses consciousness (even a brief loss of consciousness should be taken seriously.)

HOW TO RESPOND TO A REPORT OF A CONCUSSION:

If a student reports one or more symptoms of a concussion after a bump, blow, or jolt to the head or body, s/he should be kept out of athletic play the day of the injury. The student should only return to play with permission from a health care professional experienced in evaluating for concussion. During recovery, rest is key. Exercising or activities that involve a lot of concentration (such as studying, working on the computer, or playing video games) may cause concussion symptoms to reappear or get worse. Students who return to school after a concussion may need to spend fewer hours at school, take rest breaks, be given extra help and time, and spend less time reading, writing, or on a computer. After a concussion, returning to sports and school is a gradual process that should be monitored by a healthcare professional.

Remember: Concussion affects people differently. While most students with a concussion recover quickly and fully, some will have symptoms that last for days or even weeks. A more serious concussion can last for months or longer.

To learn more, go to www.cdc.gov/concussion.

CONCUSSION AWARENESS

EDUCATIONAL MATERIAL ACKNOWLEDGEMENT FORM

By responding below, I acknowledge in accordance with Public Acts 342 and 343 of 2012 that our family has received and reviewed the Concussion Fact Sheet for Parents and/or the Concussion Fact Sheet for Students provided by Traverse City Bulldogs Athletic Association, the Sponsoring Organization
(1 required) Our family has reviewed the above Concussion Sheet
EMERGENCY CONTACT (other than parent): 16. Name 17. Relationship 18. Phone