SportsEngine Registration: Prior Lake Athletics for Youth

Concussion Proof of Certification

Information
Review
Confirmation

Information

1. Please take the Free Concussion Certification Test found here:

https://nfhslearn.com/courses/concussion-in-sports-2

2. Return here to submit your certification information

3. This list is current as of Feb. 6, 2020 - if you registered since this date - your Cert. would be saved in the Master Copy. If you are not on the list on 'Steps to Coach' page you should renew your Cert.

First Name:*

Last Name:*

Address 1:*

Address 2:

City:*

State/Province:*

Zip:*

Email:*

Phone Number 1:*

Phone Number 2:

Team Affiliation:

Did you pass the concussion test?:*

Please Upload a Copy of Your Certificate:*

You are requred to keep a copy of this certificate to support future auditing

Electronic Signature:*