SBGLA Injury and Concussion Policy and Reporting Form





Sports injuries and concussions are a growing concern in youth sports.  To provide for the safety of our players, to the best of our ability, we are adopting this policy for our players, parents, coaches, trainers and members of the Board of Directors to set standards of conduct for incidents of injury and concussion or potential concussion.

In order to improve the safety of lacrosse, SBGLA will request that all teams in the league report any injuries that happen during practices or games that cause the player to miss playing or practice time and/or to visit a medical provider.

In the case of concussion or suspected concussion, SBGLA will:

  1. Educate Coaches, Parents, and Players: Inform and educate coaches, athletes, and their parents and guardians about concussion through training and/or a concussion information sheet. Links to US Lacrosse Concussion Information Site ( and the CDC Heads Up Youth Sports Site ( will be provided on the SBGLA website. Parents and players will be required to sign a waiver stating they have been informed of the risks of concussion associated with youth sports play.  All coaches and administrators will be required to complete concussion and head injury education. A summary of this policy will also be provided on the SBGLA website.
  2. Remove Player from Play: A player who is believed to have a concussion is to be removed from play right away.
  3. Obtain Permission to Return to Play: A player can only return to play or practice after at least 24 hours and with written permission from a health care professional. We recommend contacting the Cottage Concussion Clinic ( where free diagnosis and treatment is available.

As a result of the adoption of the State of California Health and Safety Code 124235(b)(3), all suspected incidences of a concussion are required to be reported via the SBGLA Concussion and Serious Injury Report form. Club administrators, coaches and parents are required to complete the form as part of the Return to Play Protocol set forth in Item 3. Club administrators are required to update the clearance to play information before an athlete can return to play. All parties are to keep a record of the initial report. SBGLA recommends that the Programs Committee Chair complete and track the injuries reported to SBGLA.

This information will only be used in efforts to improve the safety of the sport and to comply with the CA Health and Safety Code. Team and player information will never be shared publicly.








Name of Player:                                                                                                                                 

Division and Team:                                                                                                                           

Your Name:                                                                                                                                       

Your Telephone Number:                                                                                                                  

Your Email Address:                                                                                                                         

Date and Time of Event:                                                                                                                    

Place of Event:                                                                                                                                   

Detailed Description of the Incident:                                                                                              





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