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Web physical exam & clearance & consent forms • to be completed by parent or guardian or 18‐year‐old. This form helps determine if a. Daily physical activity is a key component of a healthy lifestyle..

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Name (First, Middle, Last) Date Of.

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The following information is requested so that the school can work with the parent to meet the physical, intellectual and emotional. • must be signed in two places on this page by parent or. Schools may download or order any applicable forms below. 8/22/12 page 2 of 2 copy both sides of this form for.

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Web adapted from the american academy of pediatrics ppe preparticipation physical evaluation fourth ed. Michigan high school athletic association. Obtain treatment and medical care for the child. This form must be completed by a physician, physician assistant or nurse practitioner.