Safety Guidelines for Secondary Interschool Athletics in Alberta

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3. Facility Area: Gymnasium Hallway/Stairway Rink In transit to or from School Playing Field/Tarmac Pool Locker Room/Shower Other: ____________________ 4. Probable Direct Cause: Accidental collision between participants Blow delivered by an object, e.g., ball, bat Body contact (not considered a collision) in the normal course of an activity Carelessness on part of pupil Fall/trip not due to an observed external factor Fall or loss of balance where apparatus is concerned No clear or apparent cause Obstruction on playing area (object or spectator) Strain or overexertion Other: _________________________________ Briefly describe the incident:_____________________________________________________ ____________________________________________________________________________ 5. Disposition of Injured: Returned to event/activity 6. Mode of transport: Ambulance Other: ________ 7. First Aid treatments: Ice Immobilization Splint/Tape/Tensor Recommended to stop participation Team Transport Not Applicable Airway management/AR/CPR Wound management 8. Name of attendant/caregiver:_____________________________________________________ Signature: ______________________________________________ Date: ________________________________ Physician Certified First Aider Sports Therapist Trainer Other: ____________________ 9. Follow up treatment: Hospital Other: ______________________________ Family Physician None 74 10. Home Instructions:________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ NOTE: No teacher/coach or school staff shall give consent to a doctor for medical treatment of a student athlete. Safety Guidelines for Secondary Interschool Athletics in Alberta - February 2012
APPENDIX D - Sample Request to Resume Athletic Participation One of these forms is to be completed and returned to the teacher/coach by any student athlete who has missed a practice or game due to an injury or illness requiring professional medical attention. MEDICAL PROFESSIONAL FORM This form is to be completed by a medical professional, e.g., physician, chiropractor, physiotherapist. I, _________________, (name of professional) have tested/examined ___________________, (name of student athlete) after an injury/illness to or affecting his/her___________________________________, (body part) and certify that, in my professional opinion, he/she will be ready to resume participation in __________________ (name of interschool athletic activity) as of ________________________ (date). COMMENTS:________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ Signature:_______________________________________ Date:_____________________________ PARENT/GUARDIAN FORM This form is to be completed by a parent/guardian. I, ______________________________________________________________, (name of parent/guardian) acknowledge the fact that ______________________, (name of athlete) has received care for an injury/illness affecting his/her __________________, (body part) and request his/her participation in _________________________ (name of interschool athletic activity) resume on _______________________ (date). COMMENTS:_____________________________________________________________________ Signature:_______________________________________ Date:_____________________________ Safety Guidelines for Secondary Interschool Athletics in Alberta - February 2012 75
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Safety Guidelines for Secondary Int
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ii Safety Guidelines for Secondary
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TABLE OF CONTENTS Curling .........
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Types of Policies Recommended for S
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Continued from previous page Avoidi
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HOW TO USE THIS DOCUMENT How to Use
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Continued from previous page Cultur
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LOWER MAGNITUDE OF RISK SPORTS Lowe
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Continued from previous page Specia
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Continued from previous page Playin
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26 Safety Guidelines for Secondary
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Continued from previous page o No d
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Page 54 and 55: BASEBALL - FASTBALL All Interschool
Page 56 and 57: CHEER (ACROBATIC) Cheer (Acrobatic)
Page 58 and 59: CHEER (Pom) All Physical Activities
Page 60 and 61: CROSS COUNTRY RUNNING All Physical
Page 62 and 63: DIVING All Physical Activities pg.
Page 64 and 65: FOOTBALL (FLAG, TOUCH) All Physical
Page 66 and 67: GOLF All Physical Activities pg. 1l
Page 68 and 69: RUGBY (FLAG) All Physical Activitie
Page 70 and 71: SOFTBALL (SLOW-PITCH) All Physical
Page 72 and 73: TEAM HANDBALL All Physical Activiti
Page 74 and 75: TRACK AND FIELD - HIGH JUMP All Phy
Page 76 and 77: TRACK AND FIELD - POLE VAULT Track
Page 78 and 79: TRACK AND FIELD • TRIPLE JUMP •
Page 80 and 81: TRIATHLON • SWIM • BIKE • RUN
Page 82 and 83: VOLLEYBALL (INDOOR AND OUTDOOR) All
Page 84 and 85: WRESTLING All Physical Activities p
Page 88 and 89: APPENDIX A - Sample Secondary Inter
Page 90 and 91: APPENDIX B - Sample Secondary Inter
Page 92 and 93: Continued from previous page ACKNOW
Page 96 and 97: APPENDIX E - SAMPLE Form for Off-si
Page 98 and 99: Continued from previous page Have y
Page 100 and 101: Continued from previous page 5. Wha
Page 102 and 103: 82 APPENDIX I - Sample Safety Check
Page 104 and 105: APPENDIX J SAMPLE SAFETY CHECKLIST
Page 106 and 107: APPENDIX K - SAMPLE SAFETY CHECKLIS
Page 108 and 109: APPENDIX L - Sample Emergency Actio
Page 110 and 111: Appendix M - Sample Medical History
Page 112 and 113: APPENDIX O - ATHLETIC FIRST AID KIT
Page 114 and 115: APPENDIX Q - Policy for the Alberta
Page 116 and 117: Continued from previous page 5. Any
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Page 120 and 121: Continued from previous page implem
Page 122 and 123: APPENDIX S - Suggested Criteria For
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Page 126 and 127: Association Web Link Phone Squash A
Page 128 and 129: APPENDIX W - WATER SAFETY The follo
Page 130 and 131: isk level school authority supervis
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Safety Guidelines for Secondary Interschool Athletics in Alberta

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