POMPERAUG ATHLETICS
Joseph M. Velardi, Director of Athletics
Sherry Morgan, Administrative Assistant
Phone 203 262-3294
Fax 203 262-0528
jvelardi@region15.org
Process for registering for Fall Sports at Pomperaug High School
(Due by August 15)
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Read the rules and regulations on pages 2 and 3 of this document.
Read the concussion information and consent form on pages 4 & 5.
Read the cardiac arrest information and consent form on page 6.
Write in the Name, Address and Phone number of the student on page 7 of this
packet.
Both a parent and the student must sign on page 7.
The fee is $150.00. Checks only please, made out to “Region 15”. You must
send a different form and a different check for each child for each sport
that they play throughout the school year. (There is a $600.00 family
limit.)
Check the box next to the sport that the student is playing.
Check the box next to the payment option.
Attach the check to the bottom of page 7.
Only return page 7 with the attached check to:
Athletics Office
Pomperaug High School
234 Judd Rd.
Southbury, CT 06488
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You may need to submit a sports physical form to our nurses office. A yearly updated
physical is required. It is also available at www.region15.org. (click the link to
Pomperaug High School, then click “Athletics”, then click “Forms”.
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You can view the most up to date game and practice schedule for Pomperaug sports at
www.region15.org. (click the link to Pomperaug High School, then click
“Athletics”, then click “Athletic Schedule.
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Follow Pomperaug Athletics on Twitter @Pompathletics
POMPERAUG ATHLETIC RULES AND REGULATIONS FOR PARENTS AND STUDENTS
Sports at Pomperaug High School are an extracurricular activity. It is a privilege not a right to participate in interscholastic athletics at
Pomperaug High School. That privilege may be revoked at the discretion of the school. Parents have the right to set academic and
behavioral standards above and beyond the school standards for their children. Parents have the right to revoke their child’s privilege
to participate on an interscholastic team. Working together to develop responsible young people is a team effort, and we need you on
our team.
1
Pomperaug High School coaches have the sole responsibility for the selection of all team members. The team selection is
based on the subjective opinion of the coach who will consider the students’ athletic ability, sportsmanship and citizenship when
making choices.
2
The amount of playing time, the position the athlete plays and the level that they play (Varsity, JV, and Freshman) is the
sole decision of the coach. At the varsity level in particular the emphasis will be on developing the most competitive team possible
given the talent of the athletes. Younger students may play over older students. There is no guarantee of playing time particularly at
the Varsity level. It is possible that students may not play at all. Payment of a participation fee is not a guarantee of any playing time.
3
Spectators, including students, parents and others attending contests shall refrain from criticizing officials, coaches,
opponents or players. Inappropriate spectator behavior can result in banishment from contests.
4
Students must take at least 4 units of work. A unit is defined as a course that meets each day for full credit.
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Students must pass at least 4 units or the equivalent at the end of the last marking period. Incomplete grades do not count.
For fall participation a student must have received credit toward graduation at the close of the school year preceding the contest in at
least four units.
5
Students can not be 19 years old before July 1st and participate in a sport.
6
Students can not have transferred into Pomperaug from another school district without changing their address.
7
A student has 4 consecutive years of eligibility from the date of entry into the ninth grade to be eligible for interscholastic
competition. 4 years from their entry into high school, students may no longer participate in sports even though they may not have
participated in each year.
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Students cannot take lessons, play, practice or participate in any way with other coaches, instructors or teams in the same
sport while a member of the school team while the school team is in season.
9
Students cannot receive personal economic gain for participation in any sport. Students cannot receive gifts for
participating in their sport.
10
Attendance at all practices and games is mandatory, including vacation periods. Athletes and parents must realize that
missed practice time may affect the playing time of the athlete. Students who will be absent from or late to practice should speak
directly to the coach in advance. Do not pass a message via another person.
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An injured athlete who has had medical treatment cannot participate until a release from the doctor is given to the nurse and
the coach.
12
Uniforms or parts of uniforms may be worn only at the coaches’ discretion.
13
Possession, use or being under the influence of alcohol, tobacco or illegal drugs (including steroids or other performance
enhancing drugs) on school grounds, at school functions off school grounds, en route to, during, or driving from a contest is strictly
forbidden. As a result of this infraction an athletic penalty will be imposed ranging from a three week suspension up to removal from
the team for the remainder of the season. The CIAC may institute stricter rules which would supersede this school policy. Coaches
may institute stricter rules which would supersede this policy.
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Athletes are expected to maintain the highest order of sportsmanship at all times.
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Pomperaug High School and the CIAC do not, in any way, sanction, encourage or condone “Captain’s Practice”. Students
should not feel pressured or compelled to participate in off-season practices. Off-season practices are not sanctioned or supervised by
Pomperaug High School coaches or the athletic department. Students do not have permission to practice or play on school grounds
on their own. Athletic insurance will not cover students that are injured during unauthorized practice. Teams may hold voluntary out
of season, physical conditioning workouts with a coach.
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Teams will follow the process for selection of captains as established by the athletic department.
17
No student at Pomperaug High School may take part in bullying, initiations or hazings. Students do not have the right to
impose their will on other students, nor should they feel compelled to be initiated by others. Sport teams at Pomperaug High School
should be welcoming, comfortable and inclusive. There will be a penalty imposed on those who participate in bullying, initiations or
hazings.
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Supervision by a coach or teacher is required to use the weight room. Athletes must wear appropriate clothing and follow
all safety guidelines posted.
19
Athletes must travel to and from contests in school provided transportation with the following exceptions. With prior
permission from the coach, a student may go to and/or from a contest with his/her parent. With prior permission from the coach and a
written note from his/her parent, a student may go to and/or return from a contest with another adult. With written permission of the
parent and the prior permission of the coach, students can drive themselves to and/or from an event. No student may drive to and/or
from an athletic contest with another student. No student may be driven to and/or from an athletic contest by the coach unless the
coach has the proper licensing. Families are responsible for travel to practices that occur on weekends and for practices that do not
occur immediately after school. In addition, families may be required to provide transportation to specific contests as identified in
advance by the coach.
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Occasionally students will be dismissed early from school to travel to contests.
21
Students are financially responsible for uniforms issued to them. All uniforms must be returned to the coach at the
conclusion of the season.
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Every Pomperaug High School athlete will undergo concussion screening. Parents can obtain more information by calling
the athletic office.
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All athletes are expected to fully participate in Physical Education class. No athlete is excused from Physical Education for
athletic reasons.
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Students are responsible for their personal property. Students should never leave property unlocked. If a lock or locker is
not available students should keep the property with them at the practice area.
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An athlete who is on suspension from school is not eligible to practice or take part in a contest until he/she is allowed to
return to school.
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Student-athletes must follow all school rules.
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Coaches reserve the right to close practices to parents and other members of the public.
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Parents must pick up students within 1/2 hour of the conclusion of practices or games.
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In instances where issues or conflicts arise, parents and students shall comply with the following chain of command:
Athlete/parent or guardian should try to resolve situation directly with the coach. If the concern is not resolved, it should be addressed
to the Athletic Director. If the concern remains unresolved it should be brought to the attention of the Principal, as well as the
Athletic Director.
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In order to maintain the safest possible conditions for our students all Region 15 students are required to wear a reflective
vest if they are running or jogging on public roads that are off school campuses. This includes sports practices, out of season work
outs or any other activity connected with Region 15.
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The school may print and publish a students’ picture and name in various publications including but not limited to
newspapers, newsletters, CIAC and Region 15 Web Sites and other forms of print and electronic media.
32
Games may be cancelled with out any advanced notice for a variety of reasons. Make-up games may be rescheduled for any
day, including Saturdays, Sundays, school vacation days and holidays. Players need to keep their schedules free even on days when
games are not originally scheduled to in order to play possible make-up games. Changes will not be made to accommodate individual
students’ personal commitments.
Rev. 5/20/15
Pomperaug High School Concussion and Head Injury Student/Parent Awareness & Consent Form
NOTE: This document was developed to provide coaches with an annual review of current and relevant information
regarding concussions and head injuries. A new form is required to be read, signed, dated and kept on file by their
associated school district annually to comply with Public Act No. 14—66 AN ACT CONCERNING STUDENT ATHLETES AND
CONCUSSIONS.
A concussion is the immediate and transient alteration of neurological function in the brain caused by
mechanical acceleration and deceleration forces.
Part I – SIGNS AND SYMPTOMS OF A CONCUSSION
- A concussion should be suspected if any one or more of the following signs or symptoms are present, OR if the
coach/evaluator is unsure.
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1. Signs of a concussion may include (what the athlete looks like):
Confusion/disorientation/irritability
 Act silly/combative/aggressive
Trouble resting/getting comfortable
 Repeatedly ask same questions
Lack of concentration
 Dazed appearance
Slow response/drowsiness
 Restless/irritable
Incoherent/ slurred speech
 Constant attempts to return to play
Slow/clumsy movements
 Constant motion
Loss of consciousness
 Disproportionate/inappropriate reactions
Amnesia/memory problems
 Balance problems
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2. Symptoms of a concussion may include (what the athlete reports):
Headache or dizziness
 Oversensitivity to sound/light/touch
Nausea or vomiting
 Ringing in ears
Blurred or double vision
 Feeling foggy or groggy
Note: Public Act No. 14-66 requires that a coach MUST immediately remove a student- athlete from participating
in any intramural or interscholastic athletic activity who (A) is observed to exhibit signs, symptoms or behaviors
consistent with a concussion following a suspected blow to the head or body, or (B) is diagnosed with a
concussion, regardless of when such concussion or head injury may have occurred. Upon removal of the athlete
a qualified school employee must notify the parent or legal guardian within 24 hours that the student athletes
has exhibited the signs and symptoms of a concussion.
Part II – RETURN TO PARTICIPATION (RTP)
Currently, it is impossible to accurately predict how long concussions will last. There must be full recovery before
someone is allowed to return to participation. Connecticut Law now requires that no athlete may resume
participation until they have received written medical clearance from a licensed health care professional
(Physician, Physician Assistant, Advanced Practice Registered Nurse, Athletic Trainer) trained in the evaluation
and management of concussions.
Concussion management requirements:
1. No athlete SHALL return to participation (RTP) on the same day of concussion.
2. Any loss of consciousness, vomiting or seizures the athlete MUST be immediately transported to the hospital.
3. Close observation of an athlete MUST continue following a concussion. This should be monitored for an
appropriate amount of time following the injury to ensure that there is no escalation of symptoms.
4. Any athlete with signs or symptoms related to a concussion MUST be evaluated from a licensed health care
professional (Physician, Physicians Assistant, Advanced Practice Registered Nurse, Athletic Trainer) trained in
the evaluation and management of concussions.
5. The athlete MUST obtain an initial written clearance from one of the licensed health care professionals
mentioned above directing them into a well defined RTP stepped protocol similar to one outlined below. If at
any time signs or symptoms should return during the RTP progression the athlete should cease activity *.
6. After the RTP protocol has been successfully administered (no longer exhibits any signs or symptoms or
behaviors consistent with concussions) , final written medical clearance is required by one of the licensed
health care professionals mentioned above for them to fully return to unrestricted participation in practices
and competitions.
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5.
Medical Clearance RTP protocol (Recommended one full day between steps)2
Rehabilitation stage
Functional exercise at each stage of rehabilitation
Objective of each stage
No activity
Complete physical and cognitive rest until asymptomatic. SchoolRecovery
may need to be modified.
Light aerobic activity
Walking, swimming or stationary cycling keeping
Increase Heart Rate
intensity ,<70% of maximal exertion; no resistance training
Sport Specific Exercise Skating drills in ice hockey, running drills in soccer; no head impact
Add Movement
activities
Non-contact Training drillsProgression to more complex training drills, ie. passing drills in Exercise, coordination and cognitive load
football and ice hockey; may start progressive resistance training
Full Contact Practice
Following final medical clearance, participate in normal training Restore confidence and assess functional
activities
skills by coaching staff
*
If at any time signs or symptoms should worsen during the RTP progression the athlete should stop activity that day. If
the athlete’s symptoms are gone the next day, s/he may resume the RTP progression at the last step completed in which
no symptoms were present. If symptoms return and don’t resolve, the athlete should be referred back to their medical
provider
Part III - HEAD INJURIES
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Injuries to the head includes:
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Concussions: (See above information). There are several head injuries associated with concussions which can be
severe in nature including:
a) Second impact Syndrome - Athletes who sustain a concussion, and return to play prior to being recovered from the
concussion, are also at risk for Second Impact Syndrome (SIS), a rare but life-altering condition that can result in rapid
brain swelling, permanent brain damage or death; and
b) Post Concussion Syndrome - A group of physical, cognitive, and emotional problems that can persist for weeks,
months, or indefinitely after a concussion.
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Scalp Injury: Most head injuries only damage the scalp (a cut, scrape, bruise or swelling)… Big lumps (bruises) can
occur with minor injuries because there is a large blood supply to the scalp. For the same reason, small cuts on the head
may bleed a lot. Bruises on the forehead sometimes cause black eyes 1 to 3 days later because the blood spreads
downward by gravity;
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Skull Fracture: Only 1% to 2% of children with head injuries will get a skull fracture. Usually there are no other
symptoms except for a headache at the site where the head was hit. Most skull fractures occur without any injury to the
brain and they heal easily;
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Brain Injuries are rare but are recognized by the presence of the following symptoms:
(1)difficult to awaken, or keep awake or (2) confused thinking and talking, or (3) slurred speech, or (4) weakness of arms
or legs or (5) unsteady walking”(American Academy of Pediatrics – Healthychildren, 2010)
References:
1.
NFHS. Concussions. 2008 NFHS Sports Medicine Handbook (Third Edition). 2008: 77-82.
http://www.nfhs.org.
2.
McCrory, Paul MBBS, PhD; Meeuwisse, Willem MD, PhD; Johnston, Karen MD, PhD; Dvorak, Jiri MD; Aubry, Mark MD; Molloy,
Mick MB; Cantu, Robert MA, MD. Consensus Statement on Concussion in Sport 3rd International Conference on Concussion in Sport
Held in Zurich, November 2008. Clinical Journal of Sport Medicine: May 2009 - Volume 19 - Issue 3 - pp 185-200
http://journals.lww.com/cjsportsmed/Fulltext/2009/05000/Consensus_Statement_on_Concussion_in_Sport_3rd.1.aspx.
3.
Centers for Disease Control and Prevention. Heads Up: Concussion in High School Sports.
http://www.cdc.gov/NCIPC/tbi/Coaches_Tool_Kit.htm.
4.
U.S. Department of Health and Human Services Centers For Disease Control and Prevention. A Fact Sheet for Coaches.(2009).
Retrieved on June 16, 2010. http://www.cdc.gov/concussion/pdf/coaches_Engl.pdf
5.
American Academy of Pediatrics - Healthychildren. Symptom check: Head Injury. Retrieved on June 16, 2010.
http://www.healthychildren.org/english/tips-tools/symptom-checker/pages/Head-Injury.aspx
Resources:

Centers for Disease Control and Prevention. Injury Prevention & Control: Traumatic Brain Injury. Retrieved on June 16, 2010.
http://www.cdc.gov/TraumaticBrainInjury/index.html

Centers for Disease Control and Prevention. Heads Up: Concussion in High School Sports Guide for Coaches. Retrieved on June
16, 2010.
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Student & Parent – Sudden Cardiac Arrest Plan & Consent Form
NOTE: This document was developed to provide Parents with an annual review of current and relevant information regarding sudden
cardiac arrest. A new form is required to be read, signed, dated and kept on file by their associated school district annually to comply
with Public Act No. 14—93 AN ACT CONCERNING SUDDEN CADIAC PREVENTION.
PART I – SUDDEN CARDIAC ARREST - What is sudden cardiac arrest? Sudden cardiac arrest
(SCA) is when the heart stops beating, suddenly and unexpectedly. When this happens, blood stops
flowing to the brain and other vital organs. SCA doesn’t just happen to adults; it takes the lives of
students, too. However, the causes of sudden cardiac arrest in students and adults can be different. A
student’s SCA will likely result from an inherited condition, while an adult’s SCA may be caused by
either inherited or lifestyle issues. SCA is NOT a heart attack. A heart attack may cause SCA, but
they are not the same. A heart attack is caused by a blockage that stops the flow of blood to the
heart. SCA is a malfunction in the heart’s electrical system, causing the heart to suddenly stop
beating.
PART II - HOW COMMON IS SUDDEN CARDIAC ARREST IN THE UNITED STATES? SCA
is the #1 cause of death for adults in this country. There are about 300,000 cardiac arrests outside
hospitals each year. It is the #1 cause of death for student athletes.
PART III - WHAT ARE THE WARNING SIGNS AND SYMPTOMS? Although SCA happens
unexpectedly, some people may have signs or symptoms, such as: fainting or seizures during
exercise; unexplained shortness of breath; dizziness; extreme fatigue; chest pains; or racing heart.
These symptoms can be unclear in athletes, since people often confuse these warning signs with
physical exhaustion. SCA can be prevented if the underlying causes can be diagnosed and treated.
PART IV - WHAT ARE THE RISKS OF PRACTICING OR PLAYING AFTER EXPERIENCING
THESE SYMPTOMS? There are risks associated with continuing to practice or play after
experiencing these symptoms. When the heart stops, so does the blood that flows to the brain and
other vital organs. Death or permanent brain damage can occur in just a few minutes. Most people
who experience SCA die from it.
PART V - REMOVAL FROM PLAY Any student-athlete who shows signs or symptoms of SCA
must be removed from athletic activity and referred to a licensed health care profession trained
specifically in the treatment of cardiac care. The symptoms can happen before, during or after
activity.
PART VI - RETURN TO PLAY Before returning to play, the athlete must be evaluated. Clearance
to return to play must be in writing. The evaluation must be performed by a licensed medical
provider.
PART VII – SUMMARY OF LOCAL/REGIONAL BOARD OF EDUCATION POLICY (insert) I
have read and understand this document and understand the law requires me to annually review this
Connecticut State Department of Education Approved Sudden Cardiac Arrest Educational Plan. I
have read and understand this document the “Student & Parent – Sudden Cardiac Arrest Plan &
Consent Form” and understand the severities associated with sudden cardiac arrest and the need for
immediate treatment of any suspected condition. Parent name:
Simons Fund - http://www.simonsfund.org/ Pennsylvania Department of Health http://www.simonsfund.org/wp-content/uploads/2012/06/Parent-Handout-SCA.pdf
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Pomperaug High School Fall Sports Registration Form
(You only need to return this page. Due by August 15)
Print Student’s Name: ________________________________ Grade ______
Phone:
_____________________________________
Address:
_____________________________________
_____________________________________
_____________________________________
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By my signature, I acknowledge that I have read and understand the rules, policies and procedures as printed in “The
Pomperaug Athletic Rules and Regulations For Parents and Students”. I agree to comply with these rules and regulations.
And…
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By my signature, I understand that participation in athletics at Pomperaug High School and in Region 15
Interscholastic Athletics involves the potential for injury, which is inherent in all sports. I agree to hold Regional School
District 15 and any person connected therewith, harmless from any and all claims from bodily injury and property
damage arising from the use of facilities or during the course of an activity sponsored by the above organizations. I
give my permission for my child, named above to participate and understand that such activity involves the
potential for injury, which is inherent in all sports. Injuries are always a possibility. On rare occasions, these
injuries can be so serious as to result in total disability, paralysis or even death. And..

By my signature I have read and understand this document the “Pomperaug High School Concussion and Head Injury
Student/Parent Awareness & Consent Form” and understand the severities associated with concussions and the need for
immediate treatment of such injuries. And,

By my signature I have read and understand this document the “Student and parent sudden cardiac arrest plan and consent
form” and understand the severities associated with concussions and the need for immediate treatment of such injuries.
Signed_________________________________________Date__________________
Signed________________________________________ Date__________________
(parent)
(student)
Check one:
Boys’ Soccer
Football
Cheerleading
Cross Country
Field Hockey
Girls’ Soccer
Girls’ Swimming
Volleyball
Check One:
I have attached a check for $150.00.
We would like to be considered for exemption from this fee due to financial hardship.
We have reached the family limit of $600.00
Attach check here.
You must send a different form and attach a different check for each child, for each sport, that they play
throughout the school year. Do not attach a check if you are applying for an exemption or have reached
the family limit.
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