~icSchooli
To enroll your child(ren) in the Adrian Public Schools, the following information must be
provided.
I
f
t
./
BIRTH CERTIFICATE
A person enrolling a student for the first time must provide the school with a certified copy of
the student's birth certificate (PA 84 of 1987). Failure to comply with this request, or if the
documents are inaccurate and/or suspicious in nature, will result in the school sending
parent/guardian notification of the need to comply within 30 days or the matter will be referred
to the local law enforcement agency.
IMMUNIZATION RECORD
State law requires all new school entrants to be immunized against Hepatitis B, Measles,
Mumps, Rubella, Polio, Varicella (Chickenpox) and DTaP/DTP/DT. Upon entering the 6th grade
or higher students must have the Meningococcal vaccination (PA 386, Section 92 of 1978 as
amended). Parents/guardians must provide the school with a record showing that their child
has received all of these required immunizations or a wavier must be signed. Children who
have not completed the required immunizations will be excluded from school until such
requirements are met.
The Lenawee County Health Department is located in the Human Services Building located at
1040 S. Winter Street, Adrian, MI.
You may contact them at 264-5226 regarding
immunizations.
PROOF OF RESIDENCY
Students must attend the school district in which their parent or legal guardian maintains their
legal residence. Change of guardianship is not permitted for the purpose of attending a
specific school/school district.
Proof of legal residence is required by the school district of a parent/guardian when enrolling a
student for the first time. Acceptable forms of proof of residency include:
1
Copy of a property tax statement
1
Mortgage documents that prove ownership
1
Copy of a lease agreement
1
Copy of a utility bill
1
Age of majority students will be required to provide the same
information
A DRIVER'S LICENSE IS NOT ACCEPTABLE
./
./
./
./
REGISTRATION FORM
HOME LANGUAGE SURVEY
RACE/ETHNICITY FORM
TRANSPORTATION INFORMATION SHEET (If applicable)
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f0V03ed 814.111
Adrian Public Schools
Registration Form
Name:
Student legal First Name:
Student Cell Phone:
last School Attended: (School name, City, State)
0
Black
0
White
0
Native Hawaiian
0
Oves
Multi-Racial, specify: - - - - - - - - - -
Will be sent to the primary contact's home phone number. If you would like messages sent to other phones, please list up to 6 additional numbers in the oroer that you
2.
3.
4.
IPiaA1lA
5.
6.
list below the names of other children presently living in your home.
Relationship:
Phone:
Name of Child:
Birthdate:
Current Grade:
I Child lives With:
Relationship:
Phone:
Name of Child:
Birthdate:
Current Grade
I Child lives with:
Relationship:
Phone:
Name of Child:
Blrthdate·
Current Grade:
I Child lives with:
Relationship:
Phone:
Name of ChHd:
Birthdate:
Current Grade:
I Child lives With:
report card should be sent to non-custodial parent?
Yes. Parent Name & Address·
Is there any legal informaUon or documents that the school
should be informed of concerning the above students?
O No 0
Yes. please attad1
<"Yes or No)
Yes
No TECHNOLOGY USE POLICY
As the student's parents or legal guardians, we agree to read and uphold the school technology use policy and discuss it with
our son or daughter. We understand that internet access is a privilege provided for educational purposes. We understand that
it is impossible for the district and all LISD programs to restrict access to all controversial material. The district, including all
LISD programs, its employees and agents and individual members of the Boards of Education are released from any and all
claims or causes of action arising out of our son's or daughter's use or misuse of the Network or Network equipment. In
addition, the district and all LISD programs are indemnified of any fees, expenses or damages incurred as a result of our
son's or daughter's use or misuse of the Network or Network equipment.
D D
Yes
No EMERGENCY MEDICAL AUTHORIZATION
In case of accident involving injury, or suspected injury, or in the case of illness involving my child named on this form,
district staff and all LISD program staff will transport or secure an ambulance to transport said child to the nearest available
emergency room when on school property or away on school-related activities. School personnel will authorize an
emergency room doctor to treat my child and call another doctor for consultation and treatment in the event special treatment
is necessary, such as surgery, orthopedics, etc. School personnel will hold this authorization as long as named student is
enrolled in this school district.
Yes
No USE OF STUDENT INFORMATION
Throughout the year, students are awarded honors for academics, activities, and other miscellaneous items. In such an event,
the district, including all LISD programs, will authorize local businesses to publicize these accomplishments through
electronic or printed media. District and all LISD program personnel will authorize use of only pertinent information without
jeopardizing the security of your child.
Yes
No PHOTOGRAPHINGNIDEO TAPING
D During the course of the year, photographs and/or video may be taken for use in public relations and school-related
publications. School personnel, including all LISD programs, are authorized to supervise possible photographing or
videotaping of my child related to classes and school activities on school grounds or events. Reproductions of videotaping or
photographs may be used electronically and in print by the administration for the purpose of school publicity.
D D
D D
D
POLICIES
Policies guide district staff in providing a safe and orderly atmosphere in which all students can learn. Copies of complete
policies are available at your school, online at www.theadrianmaples.com or from the Administrative Offices. Any time you
have a question or concern, please request a copy of a policy. The following policies are reviewed at the beginning of
each school year with students, but we ask that parents review them as well with their child(ren).
• Attendance Policy- District
• Bullying Policy
• Technology Policy
• Harassment Policy
• Administering of Medications Policy
• Religion Policy
• Weapons Policy
• Student Code of Conduct
• Code of Student Conduct Bus Rules
• AHS Student Handbook (On the Web Only)
PARENT/STUDENT ACKNOWLEDGEMENT
We, the undersigned, agree to read, uphold and discuss the above information/policies with our child. We understand the rights and
responsibilities pertaining to students and agree to support and abide by the rules, guidelines, procedures, and policies of the School
District and all LISD programs.
Parent or Legal Guardian Signature
Date
Student Signature
Date
This form must be signed and returned in order for the student to register.
Revised 3/5/13
drian Public Schools
Dear Parent/Guardian:
All school districts in Michigan are required to report student data by race and ethnicity categories set by the U.S.
Department of Education. Race and ethnicity data is collected utilizing a two-part question format. This allows
individuals to more accurately identify themselves given the increased diversity of our nation.
These reports help keep track of changes in student enrollment and ensure that all students receive the educational
programs and services to which they are entitled.
If we do not receive a response from you, an employee of the school district will be required to provide this
information based on observations. Federal regulations do not permit school districts to leave the questions blank.
Student's name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Grade: _ _ __
Part A is about ethnicity, not race. Regardless of what you selected in Part A, answer Part B by marking one or
more boxes to indicate what you consider your student's (or your) race to be.
11111 Is this student Hispanic/Latino? (Choose only one)
D No, not Hispanic/Latino
D Yes, Hispanic/Latino (A person of Cuban, Mexican, Puerto Rican, South or Central
American or other Spanish culture or origin, regardless ofrace.)
l@idl=j What is the student's race? (Choose one or more)
D American Indian or Alaska Native (A person having origins in any of the original
peoples ofNorth and South America, including Central America.)
D Asian (A person having origins in any of the original peoples of the Far East,
Southeast Asia, or the Indian subcontinent including, for example, Cambodia,
China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand
and Vietnam.)
D Black or African-American (A person having origins in any of the black racial
groups of Africa.)
D Native Hawaiian or Other Pacific Islander (A person having origins in any of the
original peoples of Hawaii, Guam, Samoa or other Pacific Islands.)
D White (A person having origins in any of the original peoples of Europe, the Middle
East, or North Africa.)
NOTE: Both parts A and B must be completed. We encourage you to select an answer for both parts. If either
part (A or B) is not answered, the U.S. Department of Education requires the school district to supply an
answer on your behalf.
Parent/Guardian Signature: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date: _ _ _ _ _ __
Revised 8/9/11
--.----~·····~·~--·-··-~"~~
HOME LANGUAGE SURVEY
ADRIAN PUBLIC SCHOOLS is collecting information regarding the language background of each of its students. This information will be used by the district to
determine the number of children who should be provided bilingual instruction according to Sections 380.1151 - 380.1155 of the School Code of 1995,
Michigan's Bilingual Education Law. Would you, please help by providing the following information? Thank you very much for your cooperation.
Grade: ____
Blrthdate - - - - - - - Last
SchooiBulldmg: __________________________________________________________
Name of Student:
First
Middle
1. Is your child's native tongue a language other than English? o:No
Dv-es What is that language?
,,
2. Is the primary language! used in your child's home or environm.OO,t a language other than English?
0No
DYes
What is that language? ________;___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Parent or Guardian Signature: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Date: --------,-----ParenUGuardianAddress: _________________________________________________________________________________
_
1 "Primary language" means ''the dominant language used by a person for communication."
ENCUESTA SOBRE EL IDIOMA DEL BOGAR
ADRIAN PUBLIC SCHOOLS necesita una informaci6n acerca de los idiomas que los estudiantes hablan o entienden; y acerca del idioma con el cual el estudiante ha
nacido y si lo usa en casa. Esta informaci6n sera usada por el distrito escolar para determinar el niunero de estudiantes que pueden calificar para recibir una
educaci6n bilingUe de acuerdo a las Secciones 380.1151-380.1155 del C6digo Escolar de 1995, Ley sobre la Educaci6n BilingUe de Michigan. Por favor
responda a las siguientes preguntas.
Nombre del estudiante: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Grado:__ Edad: - - - - - - - - - Segundo nombre
Apellldo
Nombre
____________________________________________________________________
Nombredesu~cucla:
~------------
1. l,Es el idioma nativol de su hijo(a) otro aparte del ingles?
0
No
0
Sf l,Cu81 es ese idioma? - - - - - - - - - - - - - - - - - - - -
2.l,Es el idioma principal usado en Ia casa o "barrio" de su hijo(a) un idioma diferente a1 ingles?
0
No
0
Sf
l,CwUeseseidioma? __~-----------------------------------------------------------------------
Firmadclpadreoguardian: _______________________________________
Domicilio Fecha: - - - - - - - Domiciliodclpadreoguardian: _________________________________________________________
1
2
Idioma nativo significa "El idioma en que el/la nifio(a) primero comenz6 a entenderse con sus padres."
"Idioma principal" significa "el idioma dominante usado por una persona para comunicarse."
STATE BOARD OF EDUCATION APPROVED HOME LANGUAGE SURVEY- Updated November 16, 2007
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Required Childhood Immunizations for Michigan School Settings
Healthcare providers in Michigan should follow the 2012 Recommended Immunization Schedule
For more information. see www.michiflan.flov/'
·
'"' "'
~.
-------------
-
Entry Requirements for All Public & Non-Public Schools
Age
Vaccine** t
~
Diphtheria,
Tetanus,
Pertussis
Polio
7 years through 18 years
including all 6th grade students
4 doses D and TOR 3 doses Td if#1 given
4 doses DTP or DTaP,
on or after 7 years of age.
one dose must be on or after 4 1 dose ofT dap* ** for children 11 through 18
years of age
years IF 5 years since the last dose of
tetanus/diphtheria containing vaccine.
4 doses, if dose 3
administered on or after 4
3 doses
years of age, only 3 doses are
required
4 years through 6 years
Measles,*
Mumps,*
Rubella*
2 doses on or after 12 months of age
Hepatitis B *
Meningococcal****
Varicella*
(Chickenpox)
3 doses
None
1 dose for children 11 years of age or older
upon entry into 6th grade or higher
2 doses of varicella vaccine at or after 12 months of age OR current lab
immunity OR reliable history of disease
* Current laboratory evidence of immunity is acceptable instead of immunization with antigen.
**All doses of vaccines must be given with appropriate spacing between doses and at appropriate ages to be considered valid.
***Tdap is required at 11 years of age or older regardless of grade.
****Meningococcal is not assessed in MCIR/SIRS if the child is 11 years of age and in a grade lower than 61h grade.
Rev. March 31, 2012
''"""''~""'~
Lenawee County
Immunizations - (517)
264-5226
HEALTH
DEPARTMENT
Who can get help? Adults, teens, and
children
Services: Vaccinations to prevent many types
of diseases
Hours: By appointment (walk-ins are
accepted as schedule permits)
1st and 3rd Wednesday (10 am to
12:45 pm) and (2 pm to 5:45pm)
2nd, 4th and 5th Wednesday (8 am to
II :45 am) and (l pm to 3:45pm)
Cost: The cost changes depending on
vaccines needed
For more information or to make an
appointment call: (517) 264-5226
Vaccines are free for children who qualifY for
the Vaccines for Children Program; children
must be 18 years or younger and
1. be in Medicaid, or
2. have medical insurance that does NOT
cover any part of their
immunizations, or
3. have no medical insurance, or
4. have medical insurance but have gone
over their annual cap for preventive
care, or
5. be an American Indian or Alaskan
native.
A $15 administration fee is charged for each
vaccine; all others will be charged at our cost.
.N;f:;lic Schoolr
Transportation Information Sheet
Student's Name:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Address:______________________________
Student's Grade:_ _ _ __
Parent's Names:________________________
Parent's Phone Numbers:____________________
Which school will your child be attending? ___________
Will your child need bussing?
DYes DNo
Will your child be picked up and dropped off at your home? DYes DNo
Will your child need to be dropped off at a daycare?
DYes DNo
If you answered yes please give the following information for the daycare:
Name:_______________________________
Address:_______________________________
Phone Number:,_____________
This information will be very helpful to us for routing purposes. Thank you for your
cooperation.
The district's transportation provider, First Student Transportation, may be reached
at 263-2464 should you have any questions.
drian Public Schools
Families in Transition Form
*THIS FORM ONLY NEEDS TO BE COMPLETED IF ANY ITEMS IN #3 APPLY
(First Name)
Date:
1. Parent(s):
(Last Name)
1.
Phone:
2.
2. Student(s):
(Last Name)
(First Name)
Living with Parent
D
D
D
D
1.
2.
3.
4.
3. Check all that apply:
D
D
D
D
D
Living with friends or relatives temporarily
Living in a shelter
Living in a hotel or motel
Foster Care placement
Student living alone or without a parent or guardian
0 CA60.
-------------~----------------~-------------------~------------------~------------------------
Families in transition may qualify for additional services such as:
* Immediate enrollment while receiving assistance retrieving birth certificates
* Immediate enrollment without a permanent address
* Student may continue to attend the same school they attended prior to the temporary move
* Transportation assistance is provided to and from school and school related activities
* School supplies, clothing assistance and personal care items
For more information please contact:
Beth McCullough, Homeless Education Liaison
Adrian Public Schools
785 Riverside A venue
Adrian, MI 49221
( 517) 266-4529
[email protected] 12 .mi. us
\
PARENT & ATHLETE CONCUSSION
INFORMATION SHEET
WHAT IS A CONCUSSION?
A concussion is a type of traumatic brain injury that
changes the way the brain normally works. A concussion
is caused by a bump, blow, or jolt to the head or body that
causes the head and brain to move quickly back and forth.
Even a “ding,” “getting your bell rung,” or what seems to be
a mild bump or blow to the head can be serious.
WHAT ARE THE SIGNS AND
SYMPTOMS OF CONCUSSION?
SYMPTOMS REPORTED
BY ATHLETE:
Signs and symptoms of concussion can show up right after
the injury or may not appear or be noticed until days or
weeks after the injury.
If an athlete reports one or more symptoms of concussion
after a bump, blow, or jolt to the head or body, s/he should
be kept out of play the day of the injury. The athlete should
only return to play with permission from a health care
professional experienced in evaluating for concussion.
DID YOU KNOW?
•
•
•
Most concussions occur without loss of
consciousness.
Athletes who have, at any point in their lives,
had a concussion have an increased risk for
another concussion.
Young children and teens are more likely to
get a concussion and take longer to recover
than adults.
•
•
•
•
•
•
•
•
•
•
Headache or “pressure” in head
Nausea or vomiting
Balance problems or dizziness
Double or blurry vision
Sensitivity to light
Sensitivity to noise
Feeling sluggish, hazy, foggy, or groggy
Concentration or memory problems
Confusion
Just not “feeling right” or is “feeling down”
SIGNS OBSERVED
BY COACHING STAFF:
•
•
•
•
•
•
•
•
•
•
Appears dazed or stunned
Is confused about assignment or position
Forgets an instruction
Is unsure of game, score, or opponent
Moves clumsily
Answers questions slowly
Loses consciousness (even briefly)
Shows mood, behavior, or personality changes
Can’t recall events prior to hit or fall
Can’t recall events after hit or fall
“IT’S BETTER TO MISS ONE GAME
THAN THE WHOLE SEASON”
Rick Snyder, Governor
James K. Haveman, Director
CONCUSSION DANGER SIGNS
In rare cases, a dangerous blood clot may form on the
brain in a person with a concussion and crowd the brain
against the skull. An athlete should receive immediate
medical attention if after a bump, blow, or jolt to the
head or body s/he exhibits any of the following danger
signs:
•
•
•
•
•
•
•
•
•
•
•
One pupil larger than the other
Is drowsy or cannot be awakened
A headache that gets worse
Weakness, numbness, or decreased coordination
Repeated vomiting or nausea
Slurred speech
Convulsions or seizures
Cannot recognize people or places
Becomes increasingly confused, restless, or agitated
Has unusual behavior
Loses consciousness (even a brief loss of consciousness
should be taken seriously)
WHY SHOULD AN ATHLETE REPORT
THEIR SYMPTOMS?
If an athlete has a concussion, his/her brain needs time to
heal. While an athlete’s brain is still healing, s/he is much
more likely to have another concussion. Repeat concussions
can increase the time it takes to recover. In rare cases,
repeat concussions in young athletes can result in brain
swelling or permanent damage to their brain. They can even
be fatal.
STUDENT-ATHLETE NAME PRINTED
STUDENT-ATHLETE NAME SIGNED
WHAT SHOULD YOU DO IF YOU THINK
YOUR ATHLETE HAS A CONCUSSION?
1. If you suspect that an athlete has a concussion,
remove the athlete from play and seek medical
attention. Do not try to judge the severity of the
injury yourself. Keep the athlete out of play the day
of the injury and until a health care professional,
experienced in evaluating for concussion, says s/he is
symptom-free and it’s OK to return to play.
2. Rest is key to helping an athlete recover from a
concussion. Exercising or activities that involve a
lot of concentration, such as studying, working on
the computer, and playing video games, may cause
concussion symptoms to reappear or get worse.
After a concussion, returning to sports and school is
a gradual process that should be carefully managed
and monitored by a health care professional.
DATE
PARENT OR GUARDIAN NAME PRINTED
PARENT OR GUARDIAN NAME SIGNED
DATE
3. Remember: Concussions affect people differently.
While most athletes with a concussion recover
quickly and fully, some will have symptoms that last
for days, or even weeks. A more serious concussion
can last for months or longer.
JOIN THE CONVERSATION
TO LEARN MORE GO TO
www.facebook.com/CDCHeadsUp
>> WWW.CDC.GOV/CONCUSSION
Content Source: CDC’s Heads Up Program. Created through a grant to the CDC Foundation from the
National Operating Committee on Standards for Athletic Equipment (NOCSAE).
Hoja informativa para los deportistas y sus
padres acerca de las conmociones cerebrales
Una conmoción es un tipo de lesión cerebral
traumática que ocasiona cambios en la forma en que
funciona el cerebro normalmente. Una conmoción
es causada por un golpe, impacto o sacudida en la
cabeza o el cuerpo que hace que la cabeza y el cerebro
se muevan rápida y repentinamente hacia adelante y
hacia atrás. Hasta un “chichoncito” o lo que pareciera
ser tan solo un golpe o una sacudida leve en la cabeza
pueden ser algo grave.
¿CUÁLES SON LOS SIGNOS Y
SÍNTOMAS DE UNA CONMOCIÓN
CEREBRAL?
Los signos y síntomas de una conmoción cerebral
pueden aparecer justo después de una lesión o
puede que no aparezcan o se noten sino hasta días o
semanas después de ocurrida la lesión.
Si un deportista presenta uno o más de los síntomas
de una conmoción cerebral indicados a continuación,
¿Sabía usted que...?
• La mayoría de las conmociones cerebrales
ocurren sin pérdida del conocimiento.
• Los deportistas que han sufrido una conmoción
cerebral en algún momento de sus vidas,
tienen un mayor riesgo de sufrir otra.
• Los niños pequeños y los adolescentes tienen
más probabilidad de sufrir una conmoción
cerebral y de que les tome más tiempo
recuperarse que los adultos.
luego de un golpe, impacto o sacudida en la cabeza o
el cuerpo, no se le debe permitir continuar jugando el
día de la lesión y no debe volver a jugar hasta que un
profesional médico con experiencia en evaluación de
conmociones cerebrales indique que ya no presenta
síntomas y que puede volver a jugar.
SIGNOS OBSERVADOS POR EL PERSONAL DE
ENTRENAMIENTO
SÍNTOMAS REPORTADOS POR LOS
DEPORTISTAS
Parece aturdido o desorientado
Dolor de cabeza o “presión” en la cabeza
Está confundido en cuanto a su posición de juego
Náuseas o vómitos
Olvida las instrucciones
Problemas de equilibrio o mareo
No está seguro del juego, de la puntuación o de adversarios
Visión borrosa o doble
Se mueve con torpeza
Sensibilidad a la luz
Responde a las preguntas con lentitud
Sensibilidad al ruido
Pierde el conocimiento (aunque sea por poco tiempo)
Sentirse débil, desorientado, aturdido, atontado o grogui
Muestra cambios de ánimo, comportamiento o personalidad
Problemas de concentración o de memoria
No puede recordar lo ocurrido antes del golpe o caída
Confusión
No puede recordar lo ocurrido después del golpe o caída
No “sentirse bien” o “con ganas de no hacer nada”
SIGNOS DE PELIGRO POR UNA
CONMOCIÓN CEREBRAL
En casos poco frecuentes, en las personas que sufren
una conmoción cerebral puede formarse un coágulo
de sangre peligroso que podría hacer que el cerebro
ejerza presión contra el cráneo. Un deportista debe
recibir atención médica de inmediato si luego de sufrir
un golpe, impacto o sacudida en la cabeza o el cuerpo
presenta alguno de los siguientes signos de peligro:
• Una pupila está más grande que la otra
• Está mareado o no se puede despertar
• Dolor de cabeza que es persistente y además empeora
• Debilidad, entumecimiento o menor coordinación
• Náuseas o vómitos constantes
• Dificultad para hablar o pronunciar las palabras
• Convulsiones o ataques
• No puede reconocer a personas o lugares
• Se siente cada vez más confundido, inquieto o agitado
• Se comporta de manera poco usual
• Pierde el conocimiento (las pérdidas del
conocimiento deben considerarse como algo serio
aunque sean breves)
¿POR QUÉ DEBE UN DEPORTISTA
NOTIFICAR A ALGUIEN SI TIENE
SÍNTOMAS?
Si un deportista sufre una conmoción, su cerebro
necesitará tiempo para sanar. Cuando el cerebro
de un deportista se está curando, tiene una mayor
probabilidad de sufrir una segunda conmoción.
Las conmociones repetidas (o secundarias) pueden
aumentar el tiempo que toma la recuperación.
En casos poco frecuentes, repetidas conmociones
Recuerde
Las conmociones cerebrales afectan a las personas de manera diferente. Si bien la mayoría de
los deportistas que sufren una conmoción cerebral se recuperan en forma completa y rápida,
algunos tienen síntomas que duran días o incluso
semanas. Una conmoción cerebral más grave
puede durar por meses o aún más.
cerebrales en los jóvenes deportistas pueden ocasionar
inflamación del cerebro o daño cerebral permanente.
Incluso pueden ser mortales.
¿QUÉ DEBE HACER SI CREE QUE
SU DEPORTISTA HA SUFRIDO
UNA CONMOCIÓN CEREBRAL?
Si considera que un deportista tiene una conmoción
cerebral, sáquelo del juego y busque atención médica
de inmediato. No intente juzgar usted mismo la
seriedad de la lesión. No permita que el deportista
regrese a jugar el mismo día de la lesión y espere
a que un profesional médico con experiencia en la
evaluación de conmociones cerebrales indique que ya
no presenta síntomas y que puede volver a jugar.
El descanso es la clave para ayudar a un deportista
a recuperarse después de una conmoción cerebral.
Durante el ejercicio o las actividades que requieran de
mucha concentración, como estudiar, trabajar en la
computadora o los juegos de video, pueden causar que
los síntomas de la conmoción cerebral reaparezcan o
empeoren. Después de una conmoción cerebral, volver
a practicar deportes y regresar a la escuela debe ser
un proceso gradual que tiene que ser controlado y
observado cuidadosamente por un profesional médico.
Mejor perder un juego que toda la temporada. Para más información sobre la conmoción
cerebral, visite: www.cdc.gov/Concussion.
Nombre del estudiante o deportista
Firma del estudiante o deportista
Fecha
Nombre del padre o tutor legal
Firma del padre o tutor legal
Fecha
Versión en español aprobada por CDC Multilingual Services – Order # 231263-2.