high school athletic physical
A completed Pre-Participation Physical Evaluation form, dated after April 1st, 2019, and the Health History Update Questionnaire and Consent Release Certificate must be on file with the Center Grove Ultimate Club (CGUC) prior to participation in any CGUC sponsored activity for the 2020 - 2021 Club season (August 1 - July 31).
If no completed Pre-Participation Physical Evaluation (PPE) form, dated after April 1st, 2019 is on file with the CGUC, a Pre-Participation Physical Evaluation (PPE) form must be completed prior to participation in any CGUC sponsored event for the 2020 - 2021 Club season (August 1 - July 31). For a PPE form to be considered approved, all items below must be completed:
Please print, complete, scan and email forms to Grier Holloway, CGUC Compliance Director, at gholloway@centergroveultimateclub.org.
If no completed Pre-Participation Physical Evaluation (PPE) form, dated after April 1st, 2019 is on file with the CGUC, a Pre-Participation Physical Evaluation (PPE) form must be completed prior to participation in any CGUC sponsored event for the 2020 - 2021 Club season (August 1 - July 31). For a PPE form to be considered approved, all items below must be completed:
- The PPE form must be signed by a physician (MD or DO) on page 3. No pre-signed or pre-stamped forms will be accepted
- The physician license number must be affixed on page 2
- The parent signatures must be affixed to the form on page 1
- The student-athlete signature must be affixed to page 1
- Pages 4 & 5 are not required
Please print, complete, scan and email forms to Grier Holloway, CGUC Compliance Director, at gholloway@centergroveultimateclub.org.
