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Youth Sports Physical Form

Youth Sports Physical Form

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Physician NO. JBER YOUTH SPORTS PROGRAM Physical Examination/Screening/Medical History Form IAW AFMAN 34-804 Each child must have a yearly physical examination to participate in youth sports. To be completed by parent/sponsor Youth s Name Date of Birth Sponsor s Name Rank Address Home Phone Date of Last Physical Work Phone EMAIL Emergency Contact Name Relationship Home Phone Number Duty Phone Number Parent s Signature Date YES There are no medical problems for the youth named above that would...
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