All Of The Necessary Sports Forms

  • THESE ARE ALL OF THE FORMS NEEDED TO TRY OUT FOR ALL SPORTS
    RETURN TO THE NURSE BEFORE THE FIRST DAY OF TRYOUTS
     

    Concussion Baseline Test - Valid for three years. Required one time only while at BRMS

     

    These are the directions for completing the on-line Baseline Concussion Test through the Atlantic Neuroscience Institute website.

    This must be completed at home with a parent/guardian supervising the student. This must be completed and the Confirmation form signed and returned to the nurse BEFORE  a student can participate in any tryout.

     

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    Concussion Test Confirmation

     
    Black River Middle School Baseline Testing Intructions
     
     
     
    Athletic Physical Exam Form - Valid for one year from the date of the exam. Required every year
     
    This form is required for participation in all school sponsored sports. The parent/guardian completes Part A (the first three pages), and the physician completes Part B. A physical exam is good for one year. This form must be into the nurse's office by the first day of try outs.

    Even if your child is not trying out for a sport, it is advisable to have this form completed and returned to your school nurse whenever you bring your child for a physical examination. This way we can keep your child's health records up to date.
     
    Athletic Physical Exam Form
     

     
     
     
    Head Injury Fact Sheet - Must be read and signed by student and parent. Required every year.
     

    This form must be signed by the parent/guardian and the student and returned to the nurse before the student is eligible to try out for any sport.

     

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    Sudden Cardiac Death Fact Sheet and Sign Off Sheet - Required every year.
     

    This form must be completed each year and returned to the Nurse before a student may participate in sports tryouts.

     
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    Sudden Cardiac Death Pamphlet Sign Off Sheet
     

    Sudden Cardiac Death Info


    Opioid Use and Misuse Educational Fact Sheet and Sign Off Sheet - Required every year.

    Opioid Sign Off Sheet

    Opioid Fact Sheet

     

     

    If Applicable:
     
    Health History Update/2nd or 3rd Sport Permission Form - Please complete this form if your child's physical exam was done more than 90 days before the first try out date.
     

    This form is also used if your child is trying out for a second or third sport during the school year. 

    For example, if your child tried out for or participated in a fall sport and she/he is trying out for a winter sport, please complete this form and return to Mrs. Pape at Black River Middle School. 

     
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    Health History Update
     

     

     

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