Athletic Physicals
LAKE BRANTLEY HIGH SCHOOL ATHLETIC PHYSICAL PAPERWORK
**If you have your physical done at the Sports Fair (May 6), all information in Part 1 and Part 2 must be completed, along with student and parent signatures, before physician will perform the physical. Please turn in paperwork that night to Mrs. Duncan at the “Athletic Table”, NOT the coach.
NEW!! – NEW!! THREE NEW FORMS FOR 2009-2010, NO NOTARIZING REQUIRED. Blue Emergency Cards will replace white cards used in 2008-2009. Turn all forms in to Athletic Office when completed – blue card needs approved and stamped. .
If you already have a current physical on file in the Athletic Office and you want to condition or try-out for a sport: you must bring the completed Blue Emergency Card to the Athletic Office. The card will be approved and stamped. Keep this card until you are ready to begin your sport.
Required for each new physical:
BLUE Athletics Emergency Card: must be completed (both sides) and parent/guardian must sign.
Form SCPS 1425: Pre-participation Physical Evaluation
Part 1: Student Information: PLEASE PRINT, complete all information.
Part 2: Medical History: Please answer yes or no to each question, explain all “yes” answers.
Student and parent/guardian MUST sign and date form.
Part 3: Physical Examination: This section must be completed by a physician. The physician
must sign, stamp and DATE the form.
Form SCPS 1425a:
Florida High School Athletic Association/School Board of Seminole County Consent and Release from Liability Certificate.
Please read, print names and sign.
Form SCPS 1425b:
Florida High School Athletic Association/School Board of Seminole County Consent and
Release from Liability Certificate.
Part 1: Please read. Student must print name, sign name and date.
Part 2: Parent gives consent regarding participation in selected sports. Please read B-D
Part 2/E: MEDICAL INSURANCE section must be completed. Insurance is a requirement.
School insurance and/or football insurance are available to purchase. Please include company name and policy number. *You must notify Athletic Office of any change in your insurance coverage.
Parents/guardians must print, sign and date form.
Birth Certificate: All freshmen and any student that has previously not participated in athletics at LBHS, must bring their ORIGINAL birth certificate, PLUS a copy to the Athletic Office.
The original will be returned immediately.
(see reverse side for further athletic information – Top Ten Things to Know About LBHS Athletics)
Questions – please call:
Cathy Duncan, Athletic Secretary – 407-746-3422
Jerri Kelly, Athletic Director – 407-746-3564
Skip Clayton, Assistant Athletic Director – 407-746-3668