Athletic Participation Forms
All students who participate in a sport must have an annual physical (valid for 365 days) with their medical home doctor (primary care physician or PCP). The school physician is available only for those students without a PCP.
Subsequent sports will require all forms (listed below), minus the annual physical. All required forms are to be handed in to the Health Office according to the deadlines located on our home page. Once processed, a “blue” card will be issued to the student. The blue card must be signed by the parent/guardian – no student will be allowed to participate without their blue card.
Please take a moment to read the welcome letter from Athletic Director.
Download Athletic Participation Packet 2015 (this is a ZIP file, so be sure to click OPEN or SAVE): Please keep in mind that we suggest you print ONLY what is needed. In order to obtain a “blue card” the following must be completed & submitted to the Health Office:
- Pre-Participation Physical Evaluation: Physical Examination Form & PCP Signature page (Good for one school year)** (3 pgs.)
- Pre-Participation Physical Evaluation: History Form – To be filled out by parent & student once a school year (2 pgs.)
- Health History Update Questionnaire – The parent or guardian of each student-athlete must complete and sign an updated health history questionnaire if the pre-participation physical examination was conducted 90 or more days prior to the first practice session of the athletic season. (1 pg.)
- Athletic Participation Approval – Must be signed by parent and student (1 pg.)
- Emergency Card – Please fill out completely – front and back and signed by parent (2 pgs.)
- Impact Testing Approval Form – To be filled out by parent and student. (1 pg.)
- Impact Testing Instructions-Home testing (1 pg)
- Universal Sign-Off page – one signature page for the next four documents (1 pg.)
- Code of Conduct – Please read carefully – parent and student must sign section on Universal Sign-Off form
- MHS Concussion Policy Statement/Fact Sheet – Please read carefully – parent and student must sign section on Universal Sign-Off form
- NJSIAA Steroid Testing Policy & Consent for Random Testing – Please read carefully – parent and student must sign section on Universal Sign-Off form
- NJ State Scholastic Student-Athlete Safety Act (Sudden Cardiac Death In Young Athletes) – pamphlet – Please read carefully – parent and student must sign form
**NOTE: On the Clearance Form of the PPE, the last item provides a signature line for the healthcare provider to attest to completion of the Student-Athlete Cardiac Assessment Professional Development Module. The module was developed in accordance with the law and is now available to physicians /
APN’s (CLICK HERE for the new guidelines). Therefore, ALL physicians (including our school physicians) and APNs, performing an athletic physical MUST complete the module and provide a copy of their certificate to
the school. A copy of the certificate will be kept on record at the
school. The Department of
Education (DOE) has provided a parent
information direction sheet. ( CLICK HERE ) The mandate will take
effect starting 2015-16 school year, affecting the Fall season first.
Athletic participation forms are reviewed by the school Dr. on Monday mornings (starting June 30th
) in the Health Office. Completeness
of these forms is then reviewed. Therefore, it may take two Mondays for blue cards to be completed.
Students will be notified through the Google Doc on Canvas when the Blue Card is complete.