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Parent/Guardian Concussion Information Acknowledgment

Each student and their parent/guardian must read and sign this Agreement each year.

  1. I wish to participate in the interscholastic sport(s) in Glenbard High School District 87.
  2. Before I will be allowed to participate, I must (a) provide the School District with a certificate of physical fitness and complete any forms required by the Illinois High School Association (IHSA).
  3. I acknowledge that I have received and read the Concussion Information I understand that Board policy 7:305, Student Athlete Concussions and Head Injuries, requires among other things that a student athlete who exhibits signs, symptoms or behaviors consistent with a concussion or head injury must be removed from participation or competition at that time and that the student will not be allowed to return to play unless cleared to do so by a physician licensed to practice medicine in all its branches or a certified athletic trainer.
  4. I am aware that with participation in sports comes the risk of injury, and I understand that the degree of danger and seriousness of risk vary significantly from one sport to another with contact sports carrying the highest  I am aware that participating in sports involves travel with the team.  I acknowledge and accept the risks inherent in the sports(s) or athletics in which I will be participating and in all travel involved.  I agree to hold the District, its employees, agents, coaches, School Board members, and volunteers harmless from any and all liability, actions, claims, or demands of any kind and nature whatsoever that may arise by or in connection with my participating in the school-sponsored interscholastic sport(s).  The terms hereof shall serve as a release and assumption of risk for my heirs, estate, executor, administrator, assignees, and for all members of my family.

To be read and signed by the parent/guardian of the student:

  1. I am the parent/guardian of the above named student and give my permission for my child or ward to participate in the interscholastic sport(s) indicated. I have read the above Agreement to Participate and understand its terms.
  2. I acknowledge having received the attached Concussion Information Sheet.
  3. I understand that all sports can involve many risks of injury, and I understand that the degree of danger and seriousness of risk vary significantly from one sport to another with contact sports carrying the higher I have received a copy of the Student Accident Benefits.   I understand that football is excluded from coverage and that I may purchase optional football coverage.  I am aware that participating in sports involves travel with the team.  In consideration of the School District permitting my child to participate, I agree to hold the District, its employees, agents, coaches, Board members and volunteers harmless from any and all liability, actions, claims or demands of any kind and nature whatsoever that may arise by or in connection with the participation of my child in the sports(s) or athletics.  I assume all responsibility and certify that my child is in good physical health and is capable of participation in the above indicated sport(s) or athletics.

My electronic acknowledgement in the registration process indicates that I have read, understand and agree to abide by the terms listed under the Concussion Information Acknowledgement.