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Madison Heights Wolverines

Madison Heights Wolverines


Dear Parents and Participants, Michigan has adopted new laws with respect to Concussion Protocols.  The Madison Heights Wolverines are required to Educate, Train and Collect specific forms in adherence to these new laws. 


Below you will find specific information regarding the new law, the required Educational Training Materials for Participants and Parents, the required Concussion Acknowledgement Form to be signed by the athlete and parent and a Medical Clearance to Return to Play Form in the event that a concussion has occurred.


The Madison Heights Wolverine Board Members and its Coaches are required to complete an online training course as well.  The Michigan Department of Community Health (MDCH) has two options for completing the online training course.  One through the Centers for Disease Control (CDC) and one through the National Federation of State High School Associa 


MHSAA note on  - Public Acts 342 & 343, Effective June 30, 2013.


Educational Training Materials and forms for Participants and Parents:

A concussion is a mild brain injury, caused by a blow, bump or jolt to the head that can have serious consequences. It can occur in any sport or recreational activity.

Michigan was the 39th U.S. state to enact a law that regulates sports concussions and return to athletic activity. The law goes into full effect on June 30th, 2013.

The sports concussion legislation requires all coaches, employees, volunteers, and other adults involved with a youth athletic activity to complete a concussion awareness on-line training program.

The organizing entity must provide educational materials on the signs/symptoms and consequences of concussions to each youth athlete and their parents/guardians and obtain a signed statement acknowledging receipt of the information for the organizing entity to keep on record.

The law also requires immediate removal of an athlete from physical participation in an athletic activity who is suspected of sustaining a concussion. The student athlete must then receive written clearance from an appropriate health professional before he or she can return to physical activity.

The information above is copied directly from the MDCH web page, the link is underlined above.

It's important to know the signs of a concussion which include:

Signs Observed by Coaching Staff

  • ·         Appears dazed or stunned
  • ·         Is confused about assignment or position
  • ·         Forgets an instruction
  • ·         Is unsure of game, score, or opponent
  • ·         Moves clumsily
  • ·         Answers questions slowly
  • ·         Loses consciousness (even briefly)
  • ·         Shows mood, behavior, or personality changes
  • ·         Can’t recall events prior to hit or fall
  • ·         Can’t recall events after hit or fall

Symptoms Reported by Athlete

  • ·         Headache or “pressure” in head
  • ·         Nausea or vomiting
  • ·         Balance problems or dizziness
  • ·         Double or blurry vision
  • ·         Sensitivity to light
  • ·         Sensitivity to noise
  • ·         Feeling sluggish, hazy, foggy, or groggy
  • ·         Concentration or memory problems
  • ·         Confusion
  • ·         Does not “feel right” or is “feeling down”

Remember, you can’t see a concussion and some athletes may not experience and/or report symptoms until hours or days after the injury. Most people with a concussion will recover quickly and fully. But for some people, signs and symptoms of concussion can last for days, weeks, or longer.

Additional information on the signs of concussions can be found in the hand out section of the website and at the Center for Disease Control: or the University of Michigan's Neuro Sport Center has a lot of information at:




Madison Heights Wolverines
P.O. Box 71887 
Madison Hts., Michigan 48071

Email: [email protected]

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