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Get VHSL Athletic Participation/Parental Consent/Physical Examination Form 2012

Physical Examination Form Separate signed form is required for each school year For School Year _______ May 1 of the current year through June 30 of the succeeding year. PART I - ATHLETIC PARTICIPATION (To be filled in and signed by the student) Male__________ Female__________ PRINT CLEARLY Name Student I.D # (Last) (First) (Middle Initial) Home Address City/Zip Code Home Address of Parents City/Zip Code Date of Birth This is my ______ semester in semester I attended Place of Birth Hig.

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