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Murray Parks & Recreation Head Injury and Concussion Policy In any sports activity run by the Murray City and every agent, coach, referee, or employee thereo f shall immediately remove a child of 18 years of age and younger from participating in a sportin g activity if the child is suspected of sustaining a concussion or a traumatic head injury. 1. The child will be prohibited from participating in any sporting activity until the chil d is evaluated by a qualified health care provider who is trained in the evaluation an d management of a concussion; and provides the City with a written statement from th e qualified health care provider stating that : the health care provider has, within three years before the day on which the written statement is made, successfully completed a continuing education cours e in the evaluation and management if a concussion; and the child is cleared to resume participation in the sport activity. 2. A child participant, or parent or legal guardian of a child participant, who suspects th e child participant may have sustained a head injury or concussion at any time during a game, class, course or season of a sports activity, regardless of location such suspecte d head injury was sustained, must immediately make it known to a City staff member . 3. Before a child is allowed to participate in any City sports activity, the parent or lega l guardian shall inform the City staff members as to whether the child participant ha s ever sustained a concussion or head injury. If a child has previously sustained a hea d injury, the parent or legal guardian shall provide City with clearance as explained in section 2 above. 4. The City, in its discretion, may consider temporary or permanent disqualification from contact sports or sports with a higher likelihood of head injury for participants wh o have previously sustained three or more concussions and experienced slowed recovery . 5 . Before the child is allowed to participate in any City sports activity, the parent or guardian or the child must sign the attached acknowledgement and release . As the parent or legal guardian of (child participant), who is participating in (sporting activity), I acknowledge that I have received a copy of, read, understand, and agree to abide by Murray City's Concussion an d Head Injury Policy (the "Policy") . I hereby state that : - [ ] my child has not previously sustained a concussion or head injury; or [ ] my child has previously sustained a concussion or head injury and I have provided the City wit h an acceptable medical clearance . I release and agree to hold harmless the City from any and all claims, demands, losses, liabilities , damages, costs and fees from concussions or head injuries that arise when I have not complied with the Policy. Signature Printed Name Date