FALL Sports 2026
  • INTERVAL HEALTH HISTORY FORM IS TO BE FILLED OUT AND SIGNED BY A PARENT/GUARDIAN AND RETURNED/EMAILED AS AN ATTACHMENT TO THE HIGH SCHOOL NURSE STARTING ON THE DATES LISTED FOR EACH TEAM AS NOTED BELOW. FORMS WILL NOTE BE ACCEPTED PRIOR TO THIS DATE PER NYSED. 
  • All required paperwork must be submitted no later than Tuesday, August 18th in order for students to be cleared for the first day of practice on August 24th
  • Modified SPORTS....ALL IHH FORMS can be returned and dated no earlier than JULY 25th 
  • Varsity SPORTS...All IHH can be returned and dated no earlier than JULY 25th
  • IHH and physical forms can be emailed to bwhalen@northcollinscsd.org or paper copies can be dropped off in the main office no later than August 18th
Email *
STUDENT NAME (Last Name, First Name) *
PARENT PHONE NUMBER  (include area code) *
GRADE (ENTERING) *
Date of last NYS Physical Examination (*Student/Parent Reported) (Enter in mm/dd/yyyy format) *please ask your parent the approximate date of your last exam. Your best guess.  *
MM
/
DD
/
YYYY
HEALTH EXAM INFORMATION
Please verify with parent or guardian the approximate date of your last physical exam. If this date does not match the school's records, you will be notified by the Health Clinic.  Required NYS School Health examination form is the only form accepted for sports participation per NYSED. Forms are valid for 1 year to include the full month of the date of the examination. Forms are available in the main office and a link is  provided for your convenience to print and submit to your primary health care provider as needed if you are instructed to complete.
Required NYS School Health Examination Form  (ONLY needed if not currently on file.)
**I acknowledge that I will require an approved  30-day Interval Health History to be  completed by my parent/guardian prior to participating in selected sport. 

**I acknowledge that my parent and I have received and read the NYS Education Department Dominic Murray Sudden Cardiac Arrest Act....Please read document below....


**I acknowledge that my parent and I have received and read the Concussion information and protocols/management. See school website for most up to date Concussion policy and the additional informational link below. 


Assumption of Risk
 *
Required
SUBMITTING YOUR 30 DAY INTERVAL HEALTH HISTORY (IHH) FORM
Parental completed IHH forms should be returned to the clinic no earlier than 30 days prior to the starting date of the sport (SEE DATES NOTED AT TOP OF THIS SIGN UP when form may be turned in). Forms are available in the main office or  a link is  provided here for your convenience. This is a fillable form to complete and print to hand in or to save and attach to an email to  bsenus@northcollinscsd.org. 
  1. IF FILLED OUT ONLINE..
  2. PLEASE SAVE TO YOUR DEVICE,  ATTACH AND EMAIL TO BWHALEN@NORTHCOLLINSCSD.ORG

SPORT *
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