SHRHS Athletic Eligibility Registration
Step 1: Turn In Physical Form
 
Athletes must have a current sports physical exam on file in the Health Office. Physicals are good for 365 days from the exact date of the last physical. Download and print the Preparticipation Physical Evaluation Form from the New Jersey Department of Education site from the link below:

Preparticipation Physical Evaluation Forms

If you have a current physical on file in the Health office but the start of your athletic season is 90 or more days after the date of your physical, you will need to fill out the Health History Update Questionnaire.  Download and print the Health History Update Questionnaire Form from the New Jersey Department of Education site from the link below:

Health History Update Questionnaire Form


The state of New Jersey now requires all students and parents to review the "Opioid Use and Misuse Fact Sheet".  Please print and return completed copy to Amy Somma.

Opioid Use and Misuse Fact Sheet
 

 If you have any questions or concerns please feel free to contact: Amy Somma
 

 
Step 2: Acknowledge Reading this Eligibility Information
 
Click HERE to Download the SHRHS Athlete Handbook
 
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  I verify that my child will be under the age of 19 prior to September, 1st. 
     
 
  Please select ALL activities your child intends on participating in this school year 
     
     
     
     
     
     
     
     
     
     
     
      
 

 
Step 3: Eligibility Registration Form

South Hunterdon Regional School

 
Random Drug and Alcohol Testing Program- *Applies to HS Students Only*
Pupil Consent to Test Form (Once per School Year)

I understand fully the performance as a participant and the reputation of my school are dependent, in part, on my conduct as an individual. I hereby agree to accept and abide by the standards, rules and regulations set forth by the South Hunetrdon Regional School District Board of Education and the sponsors for the activity in which I participate.

I authorize the South Hunterdon Regional School District to conduct a test on urine, which I provide onsite to test for alcohol and/or drug use if my name is drawn from the random pool. Pursuant to the Regulations for the Pupil Random Drug and Alcohol Testing Policy, I also authorize the release of information concerning the results of such tests to designated District personnel.

I understand that I may also be randomly drug tested for a period of one (1) calendar year from the submission of this form for any athletic or co-curricular program.
 

 

NJSIAA STEROID TESTING POLICY
CONSENT TO RANDOM TESTING

In Executive Order 72, issued December 20, 2005, Governor Richard Codey directed the New Jersey Department of Education to work in conjunction with the New Jersey State Interscholastic Athletic Association (NJSIAA) to develop and implement a program of random testing for steroids, of teams and individuals qualifying for championship games.

Beginning in the Fall, 2006 sports season, any student-athlete who possesses, distributes, ingests or otherwise uses any of the banned substances on the attached page, without written prescription by a fully-licensed physician, as recognized by the American Medical Association, to treat a medical condition, violates the NJSIAA’s sportsmanship rule, and is subject to NJSIAA penalties, including ineligibility from competition. The NJSIAA will test certain randomly selected individuals and teams that qualify for a state championship tournament or state championship competition for banned substances. The results of all tests shall be considered confidential and shall only be disclosed to the student, his or her parents and his or her school. No student may participate in NJSIAA competition unless the student and the student’s parent/guardian consent to random testing.

By signing below, we consent to random testing in accordance with the NJSIAA steroid testing policy. We understand that, if the student or the student’s team qualifies for a state championship tournament or state championship competition, the student may be subject to testing for banned substances.
 

 

Athletic Student Eligibility/Parent Permission


I understand that my son/daughter request to be enrolled as a candidate for a position on the team, an interscholastic sport at the South Hunterdon Regional High School. I fully acknowledge that the physical hazards may be encountered and hereby waive any claim for damages against the South Hunterdon Regional Board of Education or its representatives, made by me or other persons in my behalf, in case of personal injury. I am also aware that he/she must meet ALL ELIGIBILITY REQUIREMENTS, both academic and medical, which includes: a physical exam which must be reviewed and APPROVED by the School Medical Inspector, and passing a minimum of 27 1/2 credits for grades 10,11,and 12 for each year preceeding participation in fall and winter sports. To participate in spring sports, students must be passing a minimum of 13 3/4 credits for all grades during the first semester of the year. I hereby give my consent to my son's/daughter's participation in the program.
 

 

Sports-Related Concussion and Head Injury Fact Sheet and
Parent/Guardian Acknowledgement Form

A concussion is a brain injury that can be caused by a blow to the head or body that disrupts normal
functioning of the brain. Concussions are a type of Traumatic Brain Injury (TBI), which can range from mild
to severe and can disrupt the way the brain normally functions. Concussions can cause significant and
sustained neuropsychological impairment affecting problem solving, planning, memory, attention,
concentration, and behavior.

The Centers for Disease Control and Prevention estimates that 300,000 concussions are sustained during sports
related activities nationwide, and more than 62,000 concussions are sustained each year in high school contact
sports. Second-impact syndrome occurs when a person sustains a second concussion while still experiencing
symptoms of a previous concussion. It can lead to severe impairment and even death of the victim.

Legislation (P.L. 2010, Chapter 94) signed on December 7, 2010, mandated measures to be taken in order to
ensure the safety of K-12 student-athletes involved in interscholastic sports in New Jersey. It is imperative that
athletes, coaches, and parent/guardians are educated about the nature and treatment of sports related
concussions and other head injuries. The legislation states that:
• All Coaches, Athletic Trainers, School Nurses, and School/Team Physicians shall complete an
Interscholastic Head Injury Safety Training Program by the 2011-2012 school year.
• All school districts, charter, and non-public schools that participate in interscholastic sports will distribute
annually this educational fact to all student athletes and obtain a signed acknowledgement from each
parent/guardian and student-athlete.
• Each school district, charter, and non-public school shall develop a written policy describing the
prevention and treatment of sports-related concussion and other head injuries sustained by interscholastic
student-athletes.
• Any student-athlete who participates in an interscholastic sports program and is suspected of sustaining a
concussion will be immediately removed from competition or practice. The student-athlete will not be
allowed to return to competition or practice until he/she has written clearance from a physician trained in
concussion treatment and has completed his/her district’s graduated return-to-play protocol.

Quick Facts
• Most concussions do not involve loss of consciousness
• You can sustain a concussion even if you do not hit your head
• A blow elsewhere on the body can transmit an “impulsive” force to the brain and cause a concussion

Signs of Concussions (Observed by Coach, Athletic Trainer, Parent/Guardian)
• Appears dazed or stunned
• Forgets plays or demonstrates short term memory difficulties (e.g. unsure of game, opponent)
• Exhibits difficulties with balance, coordination, concentration, and attention
• Answers questions slowly or inaccurately
• Demonstrates behavior or personality changes
• Is unable to recall events prior to or after the hit or fall

Symptoms of Concussion (Reported by Student-Athlete)
• Headache
• Nausea/vomiting
• Balance problems or dizziness
• Double vision or changes in vision
• Sensitivity to light/sound
• Feeling of sluggishness or fogginess
• Difficulty with concentration, short term
memory, and/or confusion

What Should a Student-Athlete do if they think they have a concussion?
Don’t hide it. Tell your Athletic Trainer, Coach, School Nurse, or Parent/Guardian.
Report it. Don’t return to competition or practice with symptoms of a concussion or head injury. The
sooner you report it, the sooner you may return-to-play.
Take time to recover. If you have a concussion your brain needs time to heal. While your brain is
healing you are much more likely to sustain a second concussion. Repeat concussions can cause
permanent brain injury.

What can happen if a student-athlete continues to play with a concussion or returns to play to soon?
• Continuing to play with the signs and symptoms of a concussion leaves the student-athlete vulnerable to
second impact syndrome.
• Second impact syndrome is when a student-athlete sustains a second concussion while still having
symptoms from a previous concussion or head injury.
• Second impact syndrome can lead to severe impairment and even death in extreme cases.

Should there be any temporary academic accommodations made for Student-Athletes who have suffered
a concussion?

• To recover cognitive rest is just as important as physical rest. Reading, texting, testing-even watching
movies can slow down a student-athletes recovery.
• Stay home from school with minimal mental and social stimulation until all symptoms have resolved.
• Students may need to take rest breaks, spend fewer hours at school, be given extra time to complete
assignments, as well as being offered other instructional strategies and classroom accommodations.

Student-Athletes who have sustained a concussion should complete a graduated return-to-play before
they may resume competition or practice, according to the following protocol:

Step 1: Completion of a full day of normal cognitive activities (school day, studying for tests, watching
practice, interacting with peers) without reemergence of any signs or symptoms. If no return of symptoms,
next day advance.
Step 2: Light Aerobic exercise, which includes walking, swimming, and stationary cycling, keeping the
intensity below 70% maximum heart rate. No resistance training. The objective of this step is increased
heart rate.
Step 3: Sport-specific exercise including skating, and/or running: no head impact activities. The objective
of this step is to add movement.
Step 4: Non contact training drills (e.g. passing drills). Student-athlete may initiate resistance training.
Step 5: Following medical clearance (consultation between school health care personnel and studentathlete’s
physician), participation in normal training activities. The objective of this step is to restore
confidence and assess functional skills by coaching and medical staff.
Step 6: Return to play involving normal exertion or game activity.

For further information on Sports-Related Concussions and other Head Injuries, please visit:
www.cdc.gov/concussion/sports/index.html
www.nfhs.com
www.ncaa.org/health-safety
www.bianj.org
www.atsnj.org
 

 

 

South Hunterdon Regional High School
Athletic Department
ImPACT Concussion Testing Program
Parental Consent Form


Dear Parent/Guardian:

At South Hunterdon, the health and safety of our student-athletes has always been a top priority. We are now using a software program that will help to ensure the safety of our student-athletes with respect to head injuries/concussions.

The program that we are using to assess head injuries is called ImPACT (Immediate Post Concussion Assessment and Cognitive Testing). The initial/baseline test, which is given every two years, obtains a baseline measurement of a student-athlete's neurocognitive function. The computerized test measures brain processing, speed, memory, and visual motor skills and takes approximately 30 minutes to complete. ImPACT testing procedures are completely non-invasive and pose no risks to your son/daughter.

In the event that your son/daughter suffers a head injury, he/she will be re-tested and the result of that re-test will be compared to the original baseline measurement. The test data will enable our medical staff (athletic trainer, school physician and/or your child's own physician) to help determine the extent of the injury and your child's return-to-play status.

We are very excited to be able to implement this program, given that it provides us with the best information available for managing concussions. The South Hunterdon Regional High School administration, coaching, and athletic training staffs are committed to keeping you child's health and safety on the forefront of his/her experience at South Hunterdon. If you have any questions about the ImPACT program, please do not hesitate to contact me.

Sincerely,

Amy L. Somma,ATC

609-397-2060 ext. 1261

I hereby give my consent for my son/daughter to participate in the ImPACT concussion testing program. I have read and understand the information regarding ImPACT and its importance in evaluating and monitoringbrain injury. I  have read and understand the Sports-Related Concussion and Head Injury Fact Sheet and agree to abide by the concussion protocols and return-to-play guidelines adopted by South Hunterdon Regional High School. I understand that this is a "one time" consent from and by signing this form, I allow my son/daughter to participate in the ImPACT program for the duration of his/her time in South Hunterdon.
 

 
Please read the Sudden Cardiac Death in Young Athletes brochure HERE


I have read and understand the information provided in the attached link regarding Sudden Cardiac Arrest.
 

 
SOUTH HUNTERDON REGIONAL HIGH SCHOOL
ATHLETIC EMERGENCY CARD
 
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Mother's Info:
 
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Father's Info:
 
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If unable to reach parent(s), provide the name  of two adults who will assume care and transportation of child in case of injury or emergency.
 
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In the case of a medical emergency, a member of the South Hunterdon Regional High School staff, has my permission to take my child, or arrange to have my child, taken to the nearest hospital for treatment.
 

 
By clicking Send on this form, you authorize that you are the legal parent/guardian for the student named on this form, you have read and abide by the information above, and authorize this as your binding electronic signature.
 
As the Parent/Guardian of the student named above, I have read and I understand the entirety of this Eligibility Form and agree to abide by these rules.  By typing my name in the field below, I agree that the data entered here is accurate and that I am the legal parent/guardian for the student named in this form. 

I/we also acknowledge this electronic signature has the same legal effect, validity, and enforceability as a signature in a non-electronic form.
 
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