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* 1. Safe Sports Network is a community-supported nonprofit organization that provides FREE sports safety infrastructure consultation for youth leagues. Please provide your contact information so a member of our team can reach out to you.

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* 2. How would you prefer we contact you?

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* 3. How many athletes participate in your league?

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* 4. What is the minimum age of athletes who participate in your league?

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* 5. What is the maximum age of athletes who participate in your league?

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* 6. What sports does the league participate in?

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* 7. How many teams do you field per season?

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* 8. During what months of the year is your league actively participating in sports (i.e., practices and/or games)?

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* 9. How many venues does the league use for practices and games (if the same venue is used for both practices and games, please answer 1)?

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* 10. How many venue-specific emergency action plans are already in place?

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* 11. Are athletes required to submit a physical or medical information form prior to participation?

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* 12. Is there an established process for collecting and distributing medical-red-flag information to coaches with a need to know?

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* 13. Do you have a written concussion management protocol?

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* 14. Is your concussion protocol in line with New Hampshire’s concussion law?

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* 15. Does your league do baseline concussion testing?

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* 16. Is there a written athletic-injury protocol?

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* 17. Does the league keep injury records?

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* 18. What’s the procedure for athletes returning to sports after injury?

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* 19. Are you aware that Safe Sports Network offers a free drop-in Injury clinic for area athletes?

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* 20. Is there someone in your league leadership responsible for sports safety issues?

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* 21. Are your coaches required to have CPR training?

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* 22. Are your coaches required to have first-aid training?

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* 23. Is your league currently receiving any services from a sports medicine professional?

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