This sample checklist is intended to serve as a guide for stakeholders to create a checklist that aligns with the policies and procedures in their respective school division/school.

General

Communicate to teachers, coaches, and intramural supervisors:

• Teachers, coaches, and intramural supervisors are responsible for reviewing the specific activity page(s) prior to student participation in the identified activities.
• Inform the teachers, coaches, intramural supervisors on how to access Manitoba Physical Activity Safety in Schools and school board/division versions.
• Teachers may raise the requirements listed in the activity safety pages but may not lower them.
• Inform the teachers, coaches, and intramural supervisors how to access a listing of school board/division approved or not approved activities (if available).

Medical Information

• Communicate to teachers, coaches, and intramural supervisors:
• The school board/division process for reviewing and/or collecting student medical information.
• The school board/division protocols around URIS plans for students with medical conditions (for example, asthma, diabetes, anaphylaxis).

Concussion

In-service/communicate to teachers, coaches, and intramural supervisors:

• The school board/division concussion protocol (awareness, identification, management and prevention) and implementation tools.
• Their role in providing concussion awareness and prevention information to students specific to the activity.

First Aid

• Provide school board/school first aid Emergency Action Plan.
• Provide the school’s injury reporting procedures and forms that must be used for school admin., parents/guardians, and insurance providers.
• Provide teacher, coach, intramural supervisor with a first aid kit for their activity or location of first aid kit and AED within the school.

Equipment

In-service/communicate to teachers, coaches, and intramural supervisors:

• Their responsibility to visually inspect equipment prior to use.
• The procedures for reporting damaged/unsafe equipment to the principal or school designate and the removal from use.
• Their responsibility to inform students about properly wearing activity specific protective equipment.

Facilities

In-service/communicate to teachers, coaches, and intramural supervisors their responsibility to:

• Inform students that use of the activity area and equipment is prohibited without appropriate teachers supervision.
• Visually inspect facilities prior to use.
• Use school procedures to report hazardous/unsafe facilities to the principal or school designate (for example, severely uneven surfaces, holes).
• Follow school procedure to address hazardous/unsafe facilities.
• Follow school procedures for the opening and closing of gym divider doors/curtains.
• Follow school procedures for moving, securing, and storing portable goal posts.

Clothing, Footwear, Jewelry

In-service/communicate to teachers, coaches, and intramural supervisors their responsibility to:

• Communicate and enforce the expectations for students to wear activity specific appropriate clothing and footwear.
• Communicate and enforce the expectations for students to remove jewelry as indicated in the activity safety pages.

Student Safety Instructions

In-service/communicate to teachers, coaches, and intramural supervisors that:

• Students must not participate in physical activities until they’ve received safety instructions from the teacher, coach, or intramural supervisor.
• The safety instructions provided to students must be documented (students in attendance, date, time, and safety instructions provided).

Risks of the Activity

Communicate to teachers, coaches, and intramural supervisors their responsibility to:

• Communicate to students the possible risks associated with the activities, ways to minimize the risks, procedures and rules to ensure safe play, and the consequences of not following these procedures.

Environmental Considerations

In-service/communicate to teachers, coaches, and intramural supervisors:

• The school board/division procedures relating to weather and insects.

Outdoor Education Activities

Communicate to teachers the school board/division procedures related to:

• Excursion/Field Trip approval process
• Parent/Guardian consent
• Student medical information
• Swim tests
• Transportation

Outside Activity Provider

Communicate to teachers the school board/division procedures related to:

• Accessing an outside activity provider (either as part of a field trip or on-school site).

Supervision

Communicate to teachers, coaches, and intramural supervisors that:

• All activities must be supervised according to the three categories of supervision (constant visual, on site, in the area).
• A teacher, coach, or intramural supervisor who is providing instruction and is unfamiliar with an activity (for example, no recent experience) must refrain from teaching the activity until assistance is provided by appropriately trained staff or the supervisor receives appropriate training.
• Volunteers, teacher candidates, and students must not be given sole responsibility for the supervision of students.
• School expectations for change room conduct and the supervision of changes rooms must be outlined.

Additional Intramural Activity Responsibilities

Communicate to intramural supervisors their responsibility to:

• Provide expectations regarding the philosophy and organization of the school intramural program.
• Establish a process to ensure intramural officials are knowledgeable and trained to carry out their duties.
• Develop of implement rules for spectators so they do not prevent a safety concern.

Additional Interschool Activity Responsibilites

Communicate to all coaches:

• The school board/division and school coaching expectations, including all required certifications.
• Consult Coaches Expectations.
• The school interschool philosophy regarding student participation and expectations, treatments of officials, opponents, and fair play.
• The required level of first aid required that must be met for all practices and competitions (consult the First Aid section of the specific activity pages).
• The school board/division approval process for the selection of a supervisory adult to chaperone students where the coach is not the same gender as the athlete(s) and where the athlete(s) might be required to stay overnight.
• The required school board/division process for parent/guardian permission for their child/ward to participate, including acknowledgement of risk and medical information.

Consult the Sample Interschool Parent/Guardian Letter and Sample Interschool Medical Information and Consent to Participate Form.