This plan was created on:________________
Emergency Plan for Amateur Sports Teams & Leagues
TEAM/LEAGUE NAME: __________________________________________________________________
FACILITY/VENUE NAME: ________________________________________________________________
FACILITY ADDRESS: ___________________________________________________________________
Section I: Creating an Emergency Plan
1. Establish written Emergency Procedures (see separate Emergency Plan Checklist). These procedures
outline the responsibilities of the Emergency Response Team during a crisis.
2. Designate the Emergency Response Team and obtain the appropriate contact information for each
member.
3. Complete this form for each team in your league. If a team plays on multiple fields or facilities, create a
separate form for each facility/venue used.
4. Give a copy of the Emergency Plan to each member of the Emergency Response Team and make sure
each person understands their role.
5. Obtain a Participant Medical Emergency Card for all participants on your team (see Section VII).
6. Keep a copy of the Emergency Plan in a binder, along with copies of each participant’s Emergency
Medical Card, the Emergency Plan Checklist and the Incident Report forms. Have this binder ON HAND
at every practice, game and sponsored activity for quick access to this important information.
Section II: The Emergency Response Team
List the names of coaches, managers, and the certified athletic trainer who will be on site for practices,
games & activities. These members of your organization will make up your Emergency Response Team.
Also list other medical or emergency staff accessible to the team/league (ie., school’s medical staff on-site,
team doctors, campus police, etc.), who may provide additional assistance.
COACH 1
NAME:
Cell PHONE:
ADDRESS:
COACH 2
NAME:
Cell PHONE:
ADDRESS:
ASS’T COACH/MANAGER
NAME:
Cell PHONE:
ADDRESS:
ATHLETIC TRAINER
NAME:
Cell PHONE:
ADDRESS:
ON-SITE MEDICAL STAFF
NAME:
PHONE:
ADDRESS:
CAMPUS SECURITY
NAME:
PHONE:
ADDRESS:
Rev Oct. 2015
The Amateur Sports Emergency Plan is derived from the “US Lacrosse Risk Management
Manual” and the, NCAA ‘s “Sports Medicine Handbook, Guideline 1-A,”