Longview Youth Wrestling
ATHLETE & PARENT/GUARDIAN
Compliance Statement for HB 1824
Youth Sports-Head Injury Polices
Verification form for the LONGVIEW YOUTH WRESTLING program verifying that athlete
& parent/guardian have been informed of Compliance Statement HB 1824
Longview Youth Wrestling requests the use of the Longview School District facilities for the
following dates: From 1/4/2010 thru 2/27/2010
Longview Youth Wrestling, a private non-profit youth sports group, verifies all coaches,
athletes and their parent/guardian have complied with mandated policies for the management
of concussions and head injuries as prescribed by HB 1824, section 2.
Athlete (Print) (Sign) Date
Parent/Guardian (Print) (Sign) Date
*Note: Access to school facilities may not be granted until all requirements of this application are complete and
approved by the school district &/or designee.