1. A THLETIC T RAINING I NFORMATION AND P ROCEDURES Jaime Dickerson, MA, ATC Athletic Trainer 973-661-8995 jdickerson@nutleyschools.org

2. P HYSICAL I NSTRUCTIONS ALL FORMS MUST BE TURNED IN TOGETHER!! All incoming freshmen need a sports physical. This is not the same as the school physical which is turned into the nurse. Athletes cannot practice until ALL forms are turned in. Physicals must be signed off by school doctor before sports participation, therefore, forms MUST be turned in one week before practices start. All forms are due by February 14, 2013 Sports physicals are good for one calendar year. If a physical has been turned in for a previous sport an “Update” must be done.

3. U PDATED PHYSICAL “Update” means you have turned in a physical for a previous sport. Update includes the following forms. Health History Questionnaire NHS Random Drug and Alcohol Testing Nutley Media Release Form NJSIAA Random Steroid Testing NJSIAA Concussion Policy Emergency Card Athletic Parent Code of Conduct

4. F ORMS Physical Evaluation Form Health History Questionnaire Emergency Form NHS Random Drug and Alcohol Testing Nutley Media Release Form NJSIAA Random Steroid Testing NJSIAA Concussion Policy Athletic Parent Code of Conduct

5. P HYSICAL E VALUATION F ORM Form gets filled out by physician If athlete sees a separate eye doctor please have this section filled out by that physician. This is the ONLY form that will be accepted from the physician.

6. H EALTH H ISTORY Q UESTIONNAIRE Make sure the last page is signed by a parent/guardian. Explain ALL “YES” answers Any fall athlete that has turned in a physical, this form needs to be filled out instead of the physical.

7. E MERGENCY F ORM Fill out entire form. Make sure to include any medical issues or allergies that athlete has. Make sure bottom of the form is signed.

8. NHS R ANDOM D RUG AND A LCOHOL T ESTING Fill out entire form. Specify what sport on the line provided. Make sure both parent/guardian and athlete sign form.

9. M EDIA R ELEASE F ORM Be sure to check off whether permission is given or not given. Fill out form and make sure it is signed.

10. NJSIAA R ANDOM S TEROID T ESTING Make sure form is signed by the parent/guardian and the athlete. Specify what sport they are playing on the top right hand corner.

11. NJSIAA C ONCUSSION P OLICY Form is TWO pages Make sure to read both sides Make sure parent/guardian and athlete sign form.

12. A THLETIC P ARENT C ODE OF C ONDUCT Form is TWO pages Make sure to read both pages Parent MUST sign this form even if child is 18.

13. I M PACT ImPACT is a computerized test we use to baseline athletes in case of a concussion. This test should be done FRESHMEN and JUNIOR years. Sports in which this test is required: Baseball Basketball (Boy’s and Girl’s) Cheerleading (Fall and Winter) Football Ice Hockey Lacrosse Soccer (Boy’s and Girl’s) Softball Volleyball Wrestling

14. I NSTRUCTIONS FOR I M PACT T ESTING Set aside 30 minutes in a quiet room with no distractions. No headphones or cell phones. Turn off TVs, radios, or any other background noise. The test will begin with background questions called the “demographics” section. Then the “modules” will begin, which consist of: word memory, design memory, X’s and O’s, symbol match, color word match, and three letters. Read each section’s instructions carefully. To take the baseline test, go to www.impacttestonline.com/schools, select “NJ” and then click “Launch Baseline Test.”www.impacttestonline.com/schools Enter the customer code : E8B1929D28 and click “Launch Baseline Test.” Make sure Pop-ups are allowed or you will be redirected to the last page. Test results are not displayed once finished. Print out the completed test form. If you do not have access to the internet or a home computer, please contact Jaime Dickerson to arrange a testing time at school.

15. C OMPUTER R EQUIREMENTS FOR I M PACT Minimum computer requirements: Internet Explorer 6.0 or above, Firefox 1.5 or above, Safari for MAC and OSX 10.2 or above. Macromedia Flash Player 8.0 or newer. It can be downloaded at www.adobe.com www.adobe.com Pop-up blocker must be turned off for the duration of the test. Close all other programs on your computer before taking the test. Broadband Internet connection required

16. A THLETIC T RAINING P ROCEDURES All athletes are to report any and all injuries to Jaime Dickerson as soon as possible. Once Jaime is notified, the proper paperwork will be completed. If an athlete goes to the Doctor for an injury or illness, that athlete MUST give Jaime a note from that Doctor. Any taping that needs to be done will take place after school. Away games will be taped first, then home games, and then practices. Any athlete that needs to be seen for an injury will be seen after Jaime is done taping.

17. A THLETIC T RAINING R OOM R ULES No “hanging out” in the Athletic Training Room after school. One or two people per team can get water. It is not necessary for 5 people to do this. Cubbies are provided by the door, please put all personal stuff there, so it is not on the floor where people will trip over it. No cleats are allowed in the Athletic Training Room. If you come into the room in cleats, you must do 10 push-ups. No cursing in the Athletic Training Room, if you curse, you must do 15 push-ups. Jaime’s desk and everything on her desk is off limits, including her chair.

18. F OR ADDITIONAL INFORMATION Please visit the athletics website for additional information on: Pay to Participate forms Physical Forms and Instructions ImPACT test instructions WWW.NUTLEYSCHOOLS.ORG/ATHLETICS.ASPX