Sports Performance Cessation Log
Document details and reasons for stopping or withdrawing from a sports activity.
Participant Full Name
*
First Name
Last Name
Date of Cessation
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Sport or Activity
*
Please Select
Soccer
Basketball
Tennis
Swimming
Athletics
Other
Reason for Cessation
*
Injury
Fatigue
Medical condition
Personal decision
Coach's decision
Other
Please provide additional details about the reason for cessation
Was there any injury involved?
*
Yes
No
If yes, describe the injury (if applicable)
Who was present at the time of cessation?
Coach
Medical staff
Teammates
Parent/Guardian
Other
Actions taken immediately after cessation
Follow-up plan or recommendations
Contact Email
example@example.com
Signature of Participant or Responsible Person
*
Submit Log
Submit Log
Should be Empty: