JORDAN SCHOOL DISTRICT
Acknowledgment of Head Injury Policy Review
Parent Consent Form
Required under Utah Code §26-53-201
I, for
(parent or legal guardian) (student or students names)
have read, understand and agree to abide by Jordan School District Board of Education Policy
AS 97 regarding concussions and head injuries for the purposes of school-sponsored sporting
events for the school year.
Signed
Date