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Athletic Physical Clearance Form

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Keep Record of Students Health Status and Clearance.

5 PART CARBONIZED FORM

  • HELPS KEEP RECORD OF STUDENTS HEALTH STATUS AND CLEARANCE.

  • EACH SPORTS CATEGORY IS CHECKED IN REGARDS TO STUDENT'S QUALIFICATION.

  • BOTH NURSE AND ATHLETIC DIRECTOR WILL RECEIVE THEIR OWN COPY.

  • COACH WILL RECEIVE CLEARANCE COPY FOR EACH SEASONAL SPORT.

PART 1:

NURSE COPY

2:

FALL SPORT COACH

3:

WINTER SPORT COACH

4:

SPRING SPORT COACH

5:

ATHLETIC DIRECTOR COPY

FOR MORE INFORMATION OR TO PLACE AN ORDER PLEASE CALL OR FAX
 Telephone
(516) 352-5495          FAX (516) 706-3884
   

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