Athletic Forms

All students who are interested in participating in sports/intra-murals at Holdrum Middle School must fill out the forms below. Please pay attention to deadlines for each sports season. The forms below must be approved by the district physician prior to any child participating in a try-out or practice. If forms are not received by the stated deadline, we can not guarantee that a child will be cleared in time.     
 
Must be completed for participation in sports/intra-murals. Physical must have occurred within 365 days of first day of try-outs/practice.
                   -History Form (page 1) is to be filled out and signed by the parent/guardian
                  -Supplemental History Form (page 2) is to be filled out and signed by the
                    parent/guardian       
                  -Physical Examination Form (page 3) is to be completed and signed by the physician
                  -Clearance Form (page 4) is to be completed and signed by the physician
 
2. Health History Update Form (new as of 10/7/22) must be completed and signed by a parent or guardian, if a physical occurred more than 90 days prior to first day of try-outs/practice. This form must be completed for each sports season. 
 
 
3. State Mandated Athletic Fact Sheet Signoff(Required for ALL students beginning Spring 2018)
In accordance with the state laws list below, this form is to be completed and signed by the parent/guardian and student only after reviewing the following documents:
    Concussion and Head Injury Fact Sheet (N.J.S.A 18A:40-41.3)

    Sudden Cardiac Death in Young Athletes Pamphlet (N.J.S.A 18A:40-41)

    Sports Related Eye Injury Fact Sheet (N.J.S.A 18A:40-41)

    Opioid Use and Misuse Fact Sheet (N.J.S.A 18A:40-41.10)
 
          
This form must be completed and signed by the student prior to participating in any HMS Athletics. 
 
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