Drew University Recreation Department is concerned about the well being of all club sport participants. As soon as you are aware of a person suffering from a concussion on your team you must submit an Injury Report Form: drew.edu/CampusRec/club_sports/club-sport-injury-report-form
Failure to complete this form and schedule a meeting with Health Services (973-408-3414) will result in no academic accommodations being provided to you.

To ensure a safe and healthy athletic experience please read the following.

Please read below:

  • I shall familiarize themselves with the NCAA Concussion Fact Sheet for Student-Athletes. http://fs.ncaa.org/Docs/health_safety/ConFactSheetsa.pdf
  • I shall complete the Impact baseline test: impacttestonline.com/colleges CODE: 24231be597 (lower case b-e) NOTE: Remove pop-up blocker from your web browser before taking test.
  • I am aware that a concussion can affect my ability to perform everyday activities, including reaction time, balance, sleep, concentration and classroom performance. If you feel you will need special academic accommodations due to your concussion symptoms, please contact Academic Services at 973-408-3327.
  • It is my responsibility to report to a health professional if I receive a blow to the head or body and experience signs, symptoms or behaviors of a concussion as identified on the Concussion Fact Sheet for Student-Athletes. I will follow up at Health Services immediately: 973-408-3414.
  • I may notice some symptoms of a concussion immediately, but other symptoms may show up hours or days after the initial injury. It is my responsibility to report any delayed signs or symptoms to a health care professional or Health Services.
  • If I suspect myself or a teammate has a concussion, I am responsible for reporting the injury to Health Services.
  • Following a concussion, the brain needs time to heal. I am more likely to have a repeat concussion if I return to play before my symptoms resolve.  In rare cases, repeat concussions can cause permanent brain injury or death.  Because of this, I understand it is important to accurately report my signs and/or symptoms if I have been diagnosed with a concussion.
  • Long term risks and consequences of concussion are not readily known. Physical and cognitive rest is required to recover from a concussion.  In the event of a concussion I will discuss with my professors any accommodations needed to meet academic requirements.
  • Recommendations for returning to play will be made by a health professional. I understand that the Coordinator of Campus Recreation Services will consider the evaluations of the health professional and may request additional evaluations prior to allowing the club sport participant to return to play.
  • If it has been determined that I have suffered a concussion, I agree to not partake of any alcoholic beverages until effects of concussion have passed—as determined by a health professional as this could exacerbate the dangers associated with concussions.

 

I acknowledge that I have read each provision and agree to comply in regards my participation in the sport club program for the 2018-2019 Academic Year.

Concussion Agreement Waiver
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