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Sports Physical Packet

*Sports physicals are valid for 12 months

*Page 2 to be filled out by parent/guardian

*Page 3 to be filled out by physician

*Page 4 Recertification: Required if the athlete is playing a second season of sports within the same

12 month period of the valid physical exam. This form must be completed not 6 weeks prior to the first

practice day of the sports season.

*Page 5 Recertification by a Licensed Physician: this is to be filled out if Page 5 “Re-Certification by

Parent/Guardian” questions are answered “yes”

Sports physical packet must be filled out completely in order to participate in

athletics- if pages are missing from sports packet then parent/guardian will be notified

and athlete may not participate in athletics until packet is completed

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