Forms
No organization could run without a proper assortment of forms. While we are striving to make the association as paperless as possible, it is still necessary to complete a few forms to register, track important information about the wrestlers and their families, and to follow established policies.
********************************************************************************** WRESTLING WRESTLING GOALS 2008 – 2009
Each wrestler must complete this “Goals” form with their parents and have it signed. We will provide each wrestler with two copies. Turn one completed copy in by Thursday 20th November and retain one completed copy for yourself so that you can refer back to it and monitor your goals. The purpose of this form is to strengthen wrestlers in certain areas that they need improvement in.
Please circle five goals from the list below or create your own goals that you would like to be able to achieve by the end of the year. Have a great season!
Circle five GoalsI will:
1. Learn two moves from the bottom, top and neutral position and be able to execute these moves with accuracy and speed.
2. Learn to be aggressive on the mat.
3. Learn not to give up and wrestle hard to the end of the match.
4. Learn to control my emotions on and off the mat when I get beaten with respect to outbursts of temper ,crying, etc.
5. Learn to respect the referee’s decision when there is a questionable call.
6. Pledge to practice hard and learn as much as I can.
7. Finish the year with a winning record.
8. Beat wrestlers that have beaten me before.
9. Compete in as many weekend tournaments as I can.
10. Complete homework after school so that it is finished
11. by the start of practice.
12. Work hard at school to get good grades.
13. By the year end, be able to do……… (qty) pull ups.
14. By the year end, be able to do …….. (qty) of push ups.
15. Place at road warrior tournaments.
16. Place at area 7 tournament.
17. Place at league championship.
18. Place at J.O. states.
19. Make the team N.A.’s squad.
20. Not miss a practice.
21. Wash hands and shower after every practice and match.
(Please fill in any optional goals that you feel that youwould like to achieve or master )
22. …………………………………………………………………………….
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25. …………………………………………………………………………….
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27. …………………………………………………………………………….
We as coaches are very proud of all of you and embrace this opportunity to make a difference in your lives.
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Parent’s Signature
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Wrestler’s Signature
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NFHS SPORTS MEDICINE ADVISORY COMMITTEE PHYSICIAN RELEASE
FOR WRESTLER TO PARTICIPATE WITH SKIN LESION(S) FORM
The National Federation of State High School State Associations’ (NFHS) Sports Medicine Advisory Committee has developed a Physician Release for Wrestler to Participate with Skin Lesion(s) Form, which the PIAA Sports Medicine Advisory Committee recommended to the PIAA Board of Directors that it adopt effective immediately. (NOTE: The PIAA Board of Directors accepted that recommendation at its meeting of Thursday, July 24 and Friday, July 25, 2008.)
The NFHS Sports Medicine Advisory Committee conducted a survey among specialty, academic, public health, and primary care physicians and reviewed extensively the literature available on the communicability of various skin lesions at different stages of disease and treatment. No definitive data exists that allows the NFHS Sports Medicine Advisory Committee to absolutely predict when a lesion is no longer shedding organisms that could be transmitted to another. Another finding from the survey was the significant differences that exist among physicians relating to when they will permit a wrestler to return to participation after having a skin infection. Neither NFHS nor the NFHS Sports Medicine Advisory Committee presumes to dictate to professionals how to practice medicine. Neither is the information on this Form meant to establish a standard of care. The NFHS Sports Medicine Advisory Committee does believe, however, that the guidelines included on the Form represent a summary consensus of the various responses obtained from the survey, from conversations, and from literature. The NFHS Sports Medicine Advisory Committee also believes that the components of the Form are very relevant to addressing the concerns of coaches, parents, wrestlers, and physicians that lead to the research into this subject and to the development of this Form.
GOALS FOR ESTABLISHING A WIDELY USED FORM:
1. Protect wrestlers from exposure to communicable skin disorders. Although most of the skin lesions being discussed generally have no major long term consequences and are not life threatening, some do have morbidity associated with them and student-athletes should be protected from contracting skin disorders from other wrestlers or contaminated equipment such as mats.
2. Allow wrestlers to participate as soon as it is reasonably safe for them and for their opponents and/or teammates using the same mat.
3. Establish guidelines to help minimize major differences in management among physicians who are signing “return to competition forms”. Consistent use of these guidelines should protect wrestlers from catching a skin disease from participation and should protect them from inequalities as to who can or cannot participate.
4. Provide a basis to support physician decisions on when a wrestler can or cannot participate. This should help the physician who may face incredible pressure from many fronts to return a youngster to competition ASAP. This can involve “Joe Blow who never wins a match” or the next state champion with a scholarship pending.
IMPORTANT COMPONENTS FOR AN EFFECTIVE FORM:
1. Inclusion of the applicable NFHS Wrestling Rules so physicians will understand that covering a contagious lesion is not an option that is allowed by Rule. Covering a non-contagious lesion after adequate therapy to prevent injury to lesion is acceptable.
2. Inclusion of the date and nature of treatment and the earliest date a wrestler can return to participation. This should minimize the need for a family to incur the expense of additional office visits as occurs when a form must be signed within three days of wrestling, as some do.
3. Inclusion of a “bodygram” with front and back views should clearly identify the lesion in question. Using non-black ink to designate skin lesions should result in less confusion or conflict. Also including the number of lesions protects against spread after physician visit.
4. Inclusion of guidelines for minimum treatment before returning the wrestler to action as discussed above. This should enhance the likelihood that all wrestlers are managed safely and fairly.
5. Inclusion of all of the components discussed has the potential to remove the referee from making a medical decision. If a lesion is questioned, the referee’s role could appropriately be only to see if the coach can provide a fully completed Physician Release for Wrestler to Participate with Skin Lesion(s) Form allowing the wrestler to wrestle.
NATIONAL FEDERATION OF STATE HIGH SCHOOL ASSOCIATIONS SPORTS MEDICINE ADVISORY COMMITTEE
PHYSICIAN RELEASE FOR WRESTLER TO PARTICIPATE WITH SKIN LESION(S) FORM
Student’s Name:
Age: Grade:
Enrolled in ____________________________________________________________________________________________ School
Mark Location AND Number of Lesion(s) Below:
Diagnosis:
Location AND Number of Lesion(s):
Medication(s) used to treat lesion(s):
Date Treatment Started: _____ / _____ / _____ Form Expiration Date: _____ / _____ / _____
Earliest Date Above-Named Student May Return to Participation: _____ / _____ / _____
Treating Physician’s Name (print/type):
License #
Address:______________________________________________________________________
Phone:
Treating Physician’s Signature:________________________________________MD/DO (circle one) Date of Exam:_____/______/_____
NOTE TO TREATING PHYSICIAN’S: Non-contagious lesions do not require treatment prior to return to participation (e.g. eczema, psoriasis, etc.). Please become familiar with NFHS Wrestling Rules 4-2-3, 4-2-4, and 4-2-5, which provide as follows:
“ART. 3 . . . If a participant is suspected by the referee or coach of having a communicable skin disease or any other condition that makes participation appear inadvisable, the coach shall provide current written documentation as defined by the NFHS or the state associations, from a physician stating that the suspected disease or condition is not communicable and that the athlete’s participation would not be harmful to any opponent. This document shall be furnished at the weigh-in for the dual meet or tournament. The only exception would be if a designated on-site meet physician is present and is able to examine the wrestler immediately after the weigh-in. Covering a communicable condition shall not be considered acceptable and does not make the wrestler eligible to participate.” “ART. 4 . . . If a designated on-site meet physician is present, he/she may overrule the diagnosis of the physician signing the physician’s release form for a wrestler to participate with a particular skin condition.” “ART. 5 . . . A contestant may have documentation from a physician only indicating a specific condition such as a birthmark or other non-communicable skin conditions such as psoriasis and eczema, and that documentation is valid for the duration of the season. It is valid with the understanding that a chronic condition could become secondarily infected and may require re-evaluation.”
Once a lesion is not considered contagious, it may be covered to allow participation.
Below are some treatment guidelines that suggest MINIMUM TREATMENT before releasing wrestler to return to wrestling:
Bacterial Diseases (impetigo, boils): To be considered “non-contagious,” all lesions must be scabbed over with no oozing or discharge and no new lesions should have occurred in the preceding 48 hours. Oral antibiotic for three days is considered a minimum to achieve that status. If new lesions continue to develop or drain after 72 hours, CA-MRSA (Community Associated Methicillin Resistant Staphylococcus Aureus) should be considered and minimum oral antibiotics should be extended to 10 days before returning the athlete to competition or until all lesions are scabbed over, whichever occurs last.
Herpetic Lesions (Simplex, fever blisters/cold sores, Zoster, Gladiatorum): To be considered “non-contagious,” all lesions must be scabbed over with no oozing or discharge and no new lesions should have occurred in the preceding 48 hours. For primary (first episode of Herpes Gladiatorum), wrestlers should be treated and not allowed to compete for a minimum of 10 days. If general body signs and symptoms like fever and swollen lymph nodes are present, that minimum period of treatment should be extended to 14 days. Recurrent outbreaks require a minimum of 120 hours or full five days of oral anti-viral treatment, again so long as no new lesions have developed and all lesions are scabbed over.
Tinea Lesions (ringworm scalp, skin): Oral or topical treatment for 72 hours on skin and 14 days on scalp.
Scabies, Head Lice: 24 hours after appropriate topical management.
Conjunctivitis (Pink Eye): 24 hours of topical or oral medication and no discharge.
Molluscum Contagiosum: 24 hours after curettage.
Please obtain the original release form from the website: www.piaa.org
