Concussion Release | Mustang Youth Basketball

If any coach, program or league official reasonably suspects that a child has suffered a concussion, they will be removed from further basketball related activities and will not be allowed to return until the parent has provided a signed medical release statement and parent release before the player is allowed to participate in further activities, conditioning, practices or games in the Lady and Junior Mustangs Basketball program.

Parent or Guardian Consent & Release

I, the parent or guardian of the below named player in the Lady and Junior Mustangs Basketball program, have hereby given approval for his/her return to all basketball related activities, including practices and games. By checking the box below, I hereby agree that my son/daughter has been properly assessed, diagnosed and treated by the above named professional and given my permission for their unrestricted return to basketball action.

Full Name*
Player Name*
Team*
Player Grade*
Consent*
I, the parent or guardian of the above named player in the Lady and Junior Mustangs Basketball program, have hereby given approval for his/her return to all basketball related activities, including practices and games and agree with the statement above.
I, the parent or guardian of the above named player in the Lady and Junior Mustangs Basketball program, have hereby given approval for his/her return to all basketball related activities, including practices and games. By checking the box below, I hereby agree that my son/daughter has been properly assessed, diagnosed and treated by the above named professional and given my permission for their unrestricted return to basketball action.

Please note: The form above must be completed prior to a player returning to any basketball related activities.

Concussion Release Form

Parent or Guardian Consent & Release

Thank you for being a part of our program!