Little League Medical Release Form

The Little League Medical Release Form is required for all players before participating in any practices, games, or team activities. This form provides essential information about your child's medical history, allergies, current medications, and emergency contacts. It ensures that coaches and league officials can respond quickly and appropriately in the event of an injury or emergency.

How to Submit

Parents/guardians must complete and sign the Medical Release Form before the season begins. Once completed submit the form to the Safety Officer by:

• Emailing a scanned copy (preferably a PDF) with the subject line: [Child's Name] Medical Release form.

• Email address: [email protected].

WHAT TO REPORT:

• All accidents/incident which cause an injury and require First Aid, or any medical attention whether the treatment was on or off CLL site must be reported to the Safety Office within a 24-HOUR timeframe.
  
  
• Any near miss incident must be reported to the Safety Officer within a 24-HOUR timeframe.
  
  • Near Miss Incident: Where a person nearly misses being injured while at one of the Cheltenham Little League Complex's. These near misses can be a safety hazard that needs to be addressed before an actual injury does occur. (THIS HELPS CLL TO IDENTIFY SAFETY AREAS OF CONCERNS).

WHO'S RESPONSIBLE FOR FILING THE REPORT:

• Incidents/Injuries to players:
  
  
  • Managers, Coaches, Parents, and League Officials.
• Incidents/Injuries to volunteer/spectators:
  
  
  • Managers, Coaches, and League Officials.

HOW TO REPORT:

1. Complete the Incident/Injury Report Form. The form can be downloaded by clicking here.

2. All sections of the Incident/Injury Report Form must be complete.

• In an emergency situation, make sure at least the contact section of the report is complete.
  
  
• All incidents should be reported to the Safety Officer as soon as possible but no later than 24-HOURS after the incident.

RESPONSIBILITIES OF SAFETY OFFICER DURING INCIDENT/INJURY:

1. The Safety Officer will investigate all incidents/injuries and take the appropriate action.

2. The Safety Officer will contact the injured party(s) or their parents/guardian within 48-HOURS of receiving the Incident/Injury Report to ensure:

• The current condition of the injured party(s).
  
  
• To verify that all the information on the Incident/Injury Report is accurate.
  
  
• To obtain any supplemental information (as needed).

3. If a player misses seven (07) or more continuous days of participation, a physician or other accredited medical provider must give written permission for a full return to baseball/softball activity.

• This also applies to a player that seeks professional medical treatment, whether the injury took place during a CLL activity or during a non-CLL activity (ex. Hospital, Primary Doctor, and Urgent Care).

4. The Safety Officer will forward all incident/injury information to the Board of Directors.

5. The Safety Officer will continue to make periodic follow-ups as necessary until the incident/injury can be considered closed.

6. All Incident/Injury Reports will be kept on file for two years.


WHERE TO SUBMIT INCIDENT/INJURY FORM:

The Incident/Injury Reporting Form can be emailed to the following Safety Officers:

• Ari Summers
  
  
• Diana Montes
  
  
• [email protected]