Returning Student Athletes

Please print and complete the following forms PRIOR to the start of your athletic season. 

Failure to complete ALL the forms will delay the start of your season and you will be dismissed from pre-season camp.

ALL PAPERWORK IS DUE AUGUST 1, 2012.  PLEASE MAIL, FAX, EMAIL, OR SCAN DOCUMENTS TO THE SPORTS MEDICINE STAFF at:

email: SportsMedicine@becker.edu

fax: 774-354-0510

mail: Becker College Sports Medicine

964 Main Street

Leicester, MA 01524

TO BE COMPLETED BY PRIMARY CARE PHYSICIAN:

Physical Examination Form

TO BE COMPLETED BY STUDENT-ATHLETE:

Pre Season Registration- (Coming in May 2012)

Insurance Information/ Form

Contact Information & Medical History Form

Assumption of Risk

HIPAA/FERPA Form

ADD/ADHD Form (required by ALL Student-athletes, additional physician documentation may be required)