Parent’s/ Guardians & Athletes:
Ø Please open the attached “ATHLETIC –PARTICIPATION –POLICY-PARENT –LETTER” to review guidelines & deadlines for participation in Somerdale Park School Athletic Programs

Please Complete pages 1&2, then take entire form to HCP for your student’s athletic Physical & to have HCP complete pages 3&4.
Please be sure that HCP has signed & dated pages 3&4 & has applied their HCP stamp to page 4 Please note: This is the only acceptable physical form for Athletic Participation per NJ State Statute

Ø If the ATHLETIC PHYSICAL EXAM DATE PREVIOUSLY OR CURRENTLY being submitted is less than 365 days, but is greater than 90 days old on the submission deadline date for the sport your student wants to participate in, you must complete the “NJ DOE ATHLETIC HEALTH HISTORY UPDATE FORM”

Ø In addition to the above physical forms, by NJ State Statute You must read the following 2 items:

Ø After reviewing the above documents please open & sign off on the “POLICES FOR ATHLETIC PARTICIPATION PARENT/GUARDIAN ACKNOWLEDGMENT FORM”.

Please note: Print this form at home and turn it into Mrs. Dow, or you can submit it by
filling it out online and pressing the submit button in the upper right hand corner.
Please note: In order to digitally sign and submit forms, please make sure you are using INTERNET
EXPLORER. (Will NOT Work in Chrome)