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California District 55 Little League

Concussion Information Form

On a yearly basis, the youth sports organization shall give both a concussion and head injury and a sudden cardiac arrest information sheet to each athlete. The information sheet shall be signed and returned by the athlete and, if the athlete is 17 years of age or younger, shall also be signed by the athlete’s parent or guardian, before the athlete initiates practice or competition [CA HSC 124235(a)(3)(A)].

The file below is the Centers for Disease Control and Prevention (CDC) Concussion Information Form.

Parent Athlete Info Sheet

Last Modified: Jan 16, 2020