Glen Rock Public Schools Home Page
Sports Medicine
Instructor: Susan Giesemann   
Spring Athletic Forms
Athletic forms for the 2017 spring season will be collected on the following dates:

February 14th: Baseball, Softball, and Tennis
February 15th: Boys and Girls Lacrosse
February 16th: Golf and Track
February 28th: All middle school sports

All forms will be collected after school in front of the cafeteria

***If you have a physical that is on file in the nurse's office and it is within 365 days of the spring start date, only the confirmation slip will need to be handed in***
Spring Physical Cut-off Date
All high school and middle school sports: On or after March 4th 2016 or a physical from 2017
Important Information for Parents Regarding Athletic Forms, Injuries, and Insurance
All athletes are required to submit a valid annual pre-participation physical evaluation and complete the online athletic packet. Physicals must be current - within 365 days of the first day of practice. The forms included in the online athletic packet are:
  • Supplemental health history questionnaire
  • Concussion acknowledgement form
  • NJSIAA steroid form (High School only)
  • Sudden cardiac death in young athletes brochure
  • Sports related eye injuries
  • Parent-student handbook
  • Transportation permission slip
  • Student's emergency information and athletic release
  • Athletic fee
The pre-participation physical evaluation form and the confirmation slip from the online athletic packet must be handed in to the athletic trainer no later than the specified dates in order to be eligible for the first day of practice. Students submitting forms late will incur a delay in medical clearance.

  • All injuries must be reported to the coach, athletic trainer, and school nurse.
  • If an athlete visits with a physician for an injury, the athlete must provide medical documentation for the athletic trainer and school nurse. This documentation shall include the diagnosis, limitations and or recommendations, and include a return to play date. A referral form can be found below to satisfy all requirements.
  • An athlete will not be cleared to return to activity until medical documentation has been received.
  • An athlete who is returning from an injury or an illness may be required to participate in one practice before he or she competes interscholastically.
  • All intramural after school activities and sports require a valid physical on file in the nurse’s office within 365 days prior to the first official starting day.
  • Athletes injured at practice or a game will immediately notify the coach, the athletic trainer, and school nurse. If an emergency arises, the parents will be contacted immediately. The coach and the athletic trainer will complete an accident report within 48 hours of the injury. This report will be filed in the nurse’s office.
  • The athletic trainer will issue the athletic insurance claim form only upon the parent/guardian’s request.
  • It is the parent/guardian’s responsibility to submit all bills to the insurance companies.

  • All athletes must take IMPACT before they can participate in athletics.
  • Athletes are IMPACT tested every two years.
  • If an athlete sustains a concussion, he or she will need to visit with a physician who has been trained in the evaluation and management of concussions. A concussion clearance form is required to be completed and returned to the athletic trainer.
  • Athletes who sustain a concussion must check-in with the athletic trainer on a daily basis to fill out the post-concussion signs and symptoms check-list.
  • All athletes who sustain a concussion must be asymptomatic for seven days before completing the five day return to play protocol. The concussion regulation, policy, exhibit forms and protocol can be found on the athletics’ website and the athletic trainer’s fusion page.

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