HS_Athletics_Participation_Packet_2021-22

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Please complete the latest version of the DCIAA Student-Athlete Participation Packet by following the links on our website:
thedciaa.com/participation-forms
Please check that you agree before continuing.
I understand this is not a valid form. My responses will not be shared with my child's school.
Signature HereClick to Sign
Medical Insurance
06/07/2026Click to Sign
Gender
Health Conditions
Epi-Pen Used
Glasses or Contacts
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06/07/2026Click to Sign
Signature HereAthletic Trainer Will Sign Here
Your Name Here
Your Name HereClick to Sign
Signature HereStudent Will Sign Here
Signature HereClick to Sign
06/07/2026
06/07/2026Click to Sign
Prior Concussion
Prior IMPACT Test
Signature HereStudent Will Sign Here
06/07/2026
Your Name Here
Signature HereClick to Sign
06/07/2026Click to Sign
Your Name HereClick to Sign
Your Name Here
Signature HereAthletic Director Will Sign Here
06/07/2026
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