Dear Parent or Guardian:

ANY student who is interested in participating in our varsity athletic program MUST have a physical on file in the athletic office before they will be allowed to participate.

This physical is not the same as a regular physical exam administered by our family physician. It is a screening to ensure that your child is medically eligible for participation in accordance with our association’s guidelines. Memorial Day School recommends that every child receive a regular physical exam from his / her primary care physician to ensure general good health.

You will notice 4 Links below. Please download and print these forms and then follow the instructions carefully.

Permission and Medical Release Form

Fill out this form and have it signed in three (3) places by both the athlete and the parent / guardian.

Emergency and Insurance Information

This form is important should an emergency arise. Please fill this page out completely.

 Preparticipation Physical Evaluation History Form

This form must be completed and signed by both the athlete and parent / guardian.

Preparticipation Physical Evaluation – Physical Examination form and Clearance Form

This is one form that must be completed and signed by the examining physician.

When all of these forms are completed, please return them to your athlete’s coach or the school office.

Thank you for your cooperation

Mark A. Sussman

Athletic Director