Information for New Student-Athletes

To ensure that you will be eligible to participate in your respective pre-season, please fill out and return the following forms (available for download by clicking on the links to your right):

  • A completed health questionnaire and physical exam form.  Pages 1-3 completed by the student athlete, page 4 (physical) by your physician.
  • Emergency contact, insurance information, and acknowledgement of insurance requirements form.
  • Provide a front and back copy of your current insurance card.
  • Signed assumption of risk, medical consent, release of information, and referral explanation form.

Please fill out each portion of the forms completely and to the best of your knowledge. If these forms are not on file prior to the first pre-season practice you will be ineligible to participate in pre-season practices.

About the Forms

Medical history forms and pre-participation physical examinations:

These forms are a requirement for all incoming freshmen and transfer athletes in order to participate in varsity athletics at Johnson State College. Complete the medical history form. Then take the completed medical history and physical examination forms to your physician. Have him/her fill out the physical examination form.

Incoming freshmen and transfer student will not be allowed to participate in pre-season practices unless the pre-participation physical exam form is on file with the Athletic Training Office. (Please note that this is a separate form from the VSC Health Questionnaire required for admission, and the physical exam has to be within six months prior to your pre-season start date).

Insurance Forms, Emergency Contact Information, Acknowledgement of Insurance Requirements, Assumption of Risk Statement, Medical Consent, Release of Information, and Referral Explanation forms must all be signed and completed.

All athletes must fill out the insurance form in its entirety. Be sure to have the insurance policy holder sign the form.

Student athletes under the age of 18 years old must have a parent or guardian signature in the space provided on each of the forms sent by the Athletic Training staff.

IMPORTANT NOTE

All incoming first year students, transfers, and those who have not played in the past or who took a year off: The NCAA is now mandating that all physicals be completed by a physician.  We can no longer allow nurse practitioners or other health professionals to do our sports physicals; they MUST be completed by a physician.  If you are an incoming student who has filled out the health form for college entrance, I ask that you bring the JSC athletic training form to your doctor to have them fill it out.

Please return completed forms to

Renee Breault, MS, ATC, PES
Head Athletic Trainer
337 College Hill
Johnson State College
Johnson, VT 05656

or contact her by e-mail at Renee.Breault@jsc.edu or phone at (802) 635-1487.