Rowan's Law - Removal From Sport - Record (Port Dover Minor Baseball)

Print Rowan's Law - Removal From Sport - Record
When a participant is removed from sport due to a concussion or suspected concussion then the designated person shall record the incident and continue to report all training, practices, games etc that are missed due to this removal from sport. Please ensure that this form is submitted for the original incident and subsequent future events the participants misses waiting to return TO sport
  1. Port Dover Minor Baseball - Rowan's Law - Removal From Sport Record Form

    Once Completed it will be automatically Emailed to the Executive

  2. Please Use the Describe incident comment box for the following:
    • FIRST REPORT - the Initial incident description - Enter the full description of the incident
    • SECOND AND SUBSEQUENT REPORTS - To mark the form as a follow up - This is for submission of missed games and practices due to Concussion protocols - Enter Follow Up
    • FINAL REPORT  - To Submit a return to sport medical letter - Enter Returning to sport. Attach a copy of the medical letter in the return for sport section.
Player Information, Incident record
Complete this section for the initial incident. If this is a follow up for future events missed waiting on Return TO Sport use the same form, but put "Follow Up" in the Describe Initial Incident box
  1. RadDatePicker
    RadDatePicker
    Open the calendar popup.
  2. If this is follow up for missed future events awaiting a Return to Sport enter "Follow Up"
  3. RadDatePicker
    RadDatePicker
    Open the calendar popup.
    Dates missed of any training, practice or games whilst awaiting a Return to Sport
  4. RadDatePicker
    RadDatePicker
    Open the calendar popup.
    Dates missed of any training, practice or games whilst awaiting a Return to Sport
  5. RadDatePicker
    RadDatePicker
    Open the calendar popup.
    Dates missed of any training, practice or games whilst awaiting a Return to Sport
  6. RadDatePicker
    RadDatePicker
    Open the calendar popup.
    Dates missed of any training, practice or games whilst awaiting a Return to Sport
  7. RadDatePicker
    RadDatePicker
    Open the calendar popup.
    Dates missed of any training, practice or games whilst awaiting a Return to Sport
  8. RadDatePicker
    RadDatePicker
    Open the calendar popup.
    Dates missed of any training, practice or games whilst awaiting a Return to Sport
Return for Sport
Complete this section when you have a signed medical letter to return to sport
  1. RadDatePicker
    RadDatePicker
    Open the calendar popup.
    This is to tie up the original incident with the return to sport
  2. Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx.
    Maximum # Files: 3. Maximum File Size: 4MB.
Reporting Designated Person - Electronic Signature
Entry of the Full name and Date of submission is considered to be your electronic signature
  1. Of person submitting form
  2. RadDatePicker
    RadDatePicker
    Open the calendar popup.
Human Validation