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    ATHLETIC PHYSICAL FORMS
     
    THIS IS A REMINDER THAT ALL ATHLETIC PHYSICAL FORMS MUST BE SUBMITTED TO THE MJS HEALTH OFFICE BEFORE TRYOUTS IN ORDER TO GUARANTEE THEIR REVIEW BY THE SCHOOL DOCTOR.  ATHLETIC 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.  THANK YOU FOR YOUR COOPERATION.

     

     



    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  the day tryouts begin in order to be eligible. If 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 the Scholastic Student-Athlete Safety Act, mandated by the State of New Jersey, which must be completed.  These forms are available from your school nurse !
    Pre-Participation Physical Evaluation Forms must be taken with you to the doctor. Please fill out the History Form and Special Needs Supplemental Form (if applicable).
    Your physician must review the History forms and then 
    fill out the Physical Examination and Clearance Forms.
     
     
     
    ATHLETIC FORMS FOR FIRST SPORT OF THE YEAR 
    (1-8 NEED TO BE COMPLETED AND BROUGHT TO THE NURSE)    
     

    (2)

    Athletic Release Form

     (Valid for school year)

    To be completed and signed by parent/guardian.
     
    Sign Off Sheet 

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

    (4)

    Concussion Fact/Acknowledgement Form




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

    (5)

    Permission Form

     
    (R
    equired for each sport)

    To be completed and signed by the student and parent/guardian within 60 days of the
     start of 
    each sport tryout.


     

    (6)
     
    History Form & Special Needs Supplemental Form
    (if applicable)
     
    To be completed by parent/guardian and given to physician
    at time of physical examination. 
    (Valid for 90 days)

     Physical Evaluation and Clearance Form 
    To be completed by physician. (Valid for 365 days)

    (7)


    Health History Update Form

     

    (8)

    OPIOID Fact Sheet/Sign Off