Forms
Overview
Due to a recent change in State regulations, physicals must be conducted at the medical home of the student and a report sent to the school on our district form. The physical must have been completed within one year of the start of practice. Please check the calendar for the start of practice for the sport your child wishes to participate and make sure the physical has taken place within the past year. If your child uses an inhaler, you and the doctor must complete the Self Administration of Medication Form and the Asthma Action Plan before practice will be allowed.
Note: Any student who does not have a medical home, please contact the Athletics Office.
Concussion Baseline Testing
Concussion Information for Parents
Concussion Information for Athletes
Those who participate in football, girls soccer, boys soccer, wrestling, girls lacrosse, boys lacrosse, girls basketball, or boys basketball are required to take the ImPACT Concussion Baseline Test prior to participation. This test is available online. Complete the ImPACT Permission/Testing Instructions Form and return the signed form to Casey Christy or the athletics office once your son or daughter has taken the test. If you do not have access to the internet at home, you can contact the Athletic Trainer to arrange a testing time at school.
Note: Please do not take the test until you and a parent/guardian have reviewed the test taking instructions. Due to the nature of the test, it is required to use an external mouse and not a trackpad for test accuracy. Those who have already taken the online baseline Impact test during a previous school year at Eastern do not need to take it again. Invalid or low scores may require a re-take prior to participation.
Requirement: For the test to operate, please turn off pop-up blockers.
- ImPACT Online Test
- Customer ID Code: U7MRD396HT
Forms
These are all the required forms for Athletic participation. All forms are due to the Athletic Office two weeks prior to the start of practice to ensure clearance. All forms must be dated and signed within 60 days of the start of practice for the sport which your child wishes to participate. All forms can be found online or in the Athletics Office.
Basic Forms
- Athletic Participation Fee Form
The Athletic Participation Fee Form is to be completed by both the parent/guardian and is required for all sports. - Athletic Participation Permission Form
The Athletic Participation Permission Form is to be completed by both the parent/guardian and the student and is required for all sports. - Athletic Physical Form
Physical examinations must be conducted at the medical home of the student and a report sent to the school on the state developed form. The physical must have been completed within one year of the start of practice for the sport which your child wishes to participate. This Medical History Questionnaire/Parent Permission Form must be completed and submitted with the physical. This form must be presented to the physician at the time of the physical examination, reviewed by the physician and signed by the physician. A copy of a Birth Certificate is also required from all freshmen. No exceptions. - School Physician Letter
The School Physician Letters are to be completed by both the parent/guardian and the student. Please add your student's name to the two letters. - Steroid Consent Form
The Steroid Consent Form is to be completed by both the parent/guardian and the student and is required for all sports.
Extra Forms
Attention Diabetic and Asthmatic Athletes: Athletes with diabetes are advised to bring in extra snacks to be kept in the athletic trainer's office during sports participation to serve as a backup to the athlete's personal supplies. Asthmatics must have their rescue inhaler present on the field, court, etc. for all games and practices.
- Asthma Action Plan and Asthma Self Administration Form
For any athletes with Asthma, the Asthma Action Plan Asthma Self Administration Form is to be completed by both the parent/guardian, the student, and signed by the physician. - Epinephrine Release Form
For athletes requiring the use of Epinephrine, the Epinephrine Release Form is to be completed by both the parent/guardian and the student in the presence of a notary public.
Note: This form must be notarized. - ImPACT Permission Form
The ImPACT Permission Form and online test is to be completed by both the parent/guardian and the student and is required for athletes participating in football, girls soccer, boys soccer, wrestling, girls lacrosse, boys lacrosse, girls basketball, or boys basketball. - Travel Release Form
The Travel Release Form is to be completed by both the parent/guardian and the student and is required for alternate (non-school) transport of athletes to athletic events. - Weight Training Participation Permission Form
The Weight Training Participation Permission Form is to be completed by both the parent/guardian and the student and is required for any student looking to use the weight training facilities.