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ATTENTION SPRING SPORTS ATHLETES - It is time to sign-up and get forms for Winter Sports! áAll Athletes need a physical once every 365 days. áYou must get this done by your own doctor. áAnyone interested in trying out for BASEBALL, SOFTBALL, AND TRACK MUST STOP by the Nurse's office to sign-up and get the required forms or you will not be able to try out!
á
ATHLETIC PHYSICAL FORMS
á
THIS IS A REMINDER THAT ALL ATHLETIC PHYSICAL FORMS MUST BE SUBMITTED TO THE MJS HEALTH OFFICE BY THE WEEK OF FEBRUARY 20, 2017 IN ORDER TO GUARANTEE THEIR REVIEW BY THE SCHOOL DOCTOR PRIOR TO SPRING TRYOUTS. áATHLETIC FORMS CAN BE OBTAINED FROM OUR DISTRICT WEBSITE UNDER MEMORIAL JUNIOR SCHOOL, ATHLETICS.

IF YOU HAVE ANY QUESTIONS OR CONCERNS, PLEASE CONTACT OUR SCHOOL NURSE AT
973-515-2431. áTHANK YOU FOR YOUR COOPERATION.

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á

Athletic Physicals

All students wishing to participate in athletics at Memorial Junior School must have a physical examination within 365 days (1 year) of the first practice on file in the health office, and submit the additional necessary paperwork prior to átheáday tryouts begináin order to be eligible.áIf you already have had a physical within the 365 days on file you only need to fill out a Health History Update Form and Permission Slip for 2nd and 3rd sport of the year!

Listed below are the forms within theáScholastic Student-Athlete Safety Act, mandated by the State of New Jersey, which must be completed.á These forms are available from your school nurse !
Pre-Participation Physical Evaluation Formsámust be taken with you to the doctor.áPlease fill out theáHistory Form and Special Needs Supplemental Formá(if applicable).
Your physicianámustáreview the History forms and thená
fill out theáPhysical Examinationáand Clearance Forms.
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á
á
ATHLETIC FORMS FOR FIRST SPORT OF THE YEARá
(1-6 NEED TO BE COMPLETED AND BROUGHT TO THE NURSE) á á
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(2)

Athletic Release Form

á(Valid for school year)

To be completed and signed byáparent/guardian.
á
Sign Off Sheetá

Pamphlet and Sign Off Sheet to be signed by both student andáparent, return to the Nurse. á á
áá á Good for the school year. áá

(4)

Concussion Fact/AcknowledgementáForm




To be signed by both parent and student;
return signed portion to the Nurse.á
á á áGood for the school year.

(5)

Permission Form

á
(R
equired for each sport)

To be completed and signed by the student and parent/guardian withiná60ádays of the
ástart ofá
eachásport tryout.


á

(6)
á
History Formá& Special Needs Supplemental Form
(if applicable)
á
To be completed by parent/guardianáand givenáto physician
at time of physical examination.á
(Valid for 90 days)

áPhysical Evaluation and Clearance Formá
To be completed by physician. (Valid for 365 days)

(7)


Health History Update Form

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