Age Grade Concussion Protocol Form

"*" indicates required fields

Please complete the form below and return asap to titled Concussion Confidential. The County Office will then contact the following if parent/guardian has agreed: Club contacts, School/ACE/College contact, County Representative Rugby Team Manager and Lead Coach, DPP Lead Coach, Falcons Academy Contacts (Rugby Union and/or League, as appropriate) within 48 hours. Parent/Guardian will be copied in on the e-mail sent. Please ensure you have informed the appropriate people within your club/school.
DD slash MM slash YYYY
DD slash MM slash YYYY
Has the player's Parents or Guardian been informed?*
Does the parent/guardian give permission for information to be circulated*
Has the Player/Guardian been notified that information will be kept on file and are happy that paperwork will be kept for reference.*
Is the player in County DPP, County Rugby, Newcastle Falcons Academy, ACE Scheme at Gosforth Academy, Newcastle Thunder, or any other Rugby League Team?*

Age Grade Combining of Teams Form

"*" indicates required fields

Playing out of Age Grade: Important Information

The priority is always for age grade players to play in their defined age/year group, with their peers/friends and where those that support them are most closely connected. Playing out of age grade is the exception. For any player to do so, the circumstances, conditions, assessments and approvals required in regulation must be in place beforehand. The ultimate consideration must be the welfare and safety of all the players involved.

Playing Up, Down and Adult Rugby is about individual players for whom it is appropriate. Combining is applicable to groups of players joining another age group. Please note, there is a separate form for England Academy Players.

Please read Regulation 15.2 and 15.5 in detail before completing this form.

Please read the accompanying advice in the Age Grade Codes of Practice

Group Player Assessment

To include a summary of your risk assessment of bringing two years of players together (ie. Differences in skill levels & ability, physical, emotional, social development and how this was measured). It is recommended that a coach of at least England Rugby Coaching Award level (previously Level 2) makes this assessment. The Age Grade Codes of Practice provide guidance on supporting evidence and measurement.

Please note the combining of teams is NOT applicable to the Girls game as they have the new dual age bands.

The Combining of Teams Due to Player Shortage

Regulation 15.2 states
15.2 Combining of Age Grades
15.2.1 Certain age grades are permitted to be combined together for training and playing as set out in the table at Regulation 15.5.
15.2.2 If Age Grades are being combined, the following conditions must be met:
(a) the school or club does not have a sufficient number of players to make up a team in the single age grade;
(b) the school’s principal or the club’s Constituent Body provides written approval (such approval to be valid for up to one season only);
(c) no more than half the players on the pitch at any time can be from the older age grade;
(d) the team plays to the rules of the younger age grade;
Coach(es) Requesting Sign-Off*
First Name

Festival & Match Day Management

I acknowledge that on the day no more than 50% of the players on the pitch at any time will be from the older age grade.*
I acknowledge that on the day, the coaching team from BOTH clubs will manage the situation regards player safety.*
At no point can three age grades be on the pitch at the same time. Example – Under 13s and Under 12s combine at “X” Club. “Y” Club has combined Under 11s and Under 12s. They are due to play each other in a match this weekend – the coaches MUST manage the game so that NO Under 13s are playing when there are Under 11s on the pitch.
I acknowledge that on the day, the match will be played to the younger age grade regulations.*
Example 1 – U13s and U12s combined will play to U12s regulations (throughout season). Example 2 – if following the example with “X” and “Y” Clubs (U13s and U12 combined at X and U11 and U12 combined at Y), you must play to U11 regulations.
I acknowledge that on the day, if playing the older age grade players has a big influence on the score (ie one team is running away with the result and a huge gap starts to appear), the match will be stopped if there is a 30 point margin.*
If this scenario does apply and you still have time, adapt what you do for the remainder of the session – swap players, change the format (play x7s or touch) or play some fun games so your players go home with a positive outlook.

Club Sign Off

Form Submission

Please note once signed off, notification will be sent to other clubs within county so they are aware that they may be working with a combined team and can make relevant provision. It should also be noted that if you plan to play any teams from the SRU, they run different age bands to the RFU. Before agreeing to any fixture and submitting any cross border forms (applicable to ANY matches against teams from the Borders), please make sure you are able to play within the bounds of RFU Regulation 15 – if in any doubt please consult your Chair of Age Grade / CSO.

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