Rockford University Athletic Training

Rockford University Athletic Training

Pre-Participation Checklist

THESE FORMS DUE BY AUGUST 1 OF ACADEMIC YEAR!

FIRST YEAR/TRANSFER STUDENT ATHLETES:

• WELCOME LETTER- **Important information! MUST Read! (do not return, no signatures required)

• Parent Consent for Minor (parent/guardian needs to sign forms if student athlete is less than 18 yrs of age)
• Waiver of Liability & Assumption of Risk
• ADHD Medication Exemption Form (If applicable, Print form and return)
• Emergency Information
• Physical Exam (Physicals MUST be on Rockford University Physical Exam form, NO EXCEPTIONS)
• First Year/Transfer Athlete Health History
• Sickle Cell Waiver
• NCAA Sickle Cell Information Sheet
• Sickle Cell video link
• Complete the Online ImPACT Concussion Baseline Test
• Directions for online ImPACT Concussion Test
• NCAA Concussion Information Sheet
• Turn in a copy of insurance card (front/back)
• Students who have personal health insurance coverage may waive the health insurance charge by completing the on-line waiver. Waiver information can be found at the Student Assurance Services, Inc. website at and follow the directions to Illinois and Rockford University.
• A waiver must be submitted your first semester at Rockford University and every fall semester thereafter. Waivers and enrollments must be completed by the end of the second week of classes for each semester.

RETURNING STUDENT ATHLETES:

• WELCOME LETTER- **Important information! MUST Read! (Keep, do not return, no signatures required)

• Waiver of Liability & Assumption of Risk
• ADHD Medication Exemption Form (If applicable, Print form and return)
• Emergency Information
• Returning Athlete Health History
• Turn in a Copy of insurance card (front/back) **Note-only need copy if your insurance has changed from previous year
• Students who have personal health insurance coverage may waive the health insurance charge by completing the on-line waiver. Waiver information can be found at the Student Assurance Services, Inc. website at and follow the directions to Illinois and Rockford University.
• A waiver must be submitted your first semester at Rockford University and every fall semester thereafter. Waivers and enrollments must be completed by the end of the second week of classes for each semester.

Send requested items via mail, email or fax to:

Holli A. NewcomerFax: (815) 394-5077

Head Athletic Trainer

Rockford University-Athletic Training

5050 E. State St Email:

Rockford, Illinois 61108

*Completed medical forms are due by August 1 no matter what sport you will be participating in

*Please keep a copy of the completed forms for your records