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Scps Form Physical 2009-2023
Parent/Guardian: ________________________________
City
Emergency Contact ____________________ Relationship to Student: __________ Home # (_____) _________ Work # (_____) ________________
Family Physician: __________________________City _____________ Office Phone: (_____) ____________Previous School_________________
PART 2: Verification of medical insurance: Insurance coverage is required for participation in athletic events.
Athletes must have personal insurance coverage or school...
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