Adopted: September 1977
Revised: July 2012
Download 604.4.1AR - Medical Eligibility for Students Participating in Cocurricular Activities
1. Documentation for Participation
Any student in grades 7-12 who intends to participate in interscholastic athletics, danceline or cheerleading must have the following documents on file in his or her school office prior to the student’s participation:
1.1 A record of a physical examination (Minnesota State High School League Sports Qualifying Physical Examination Clearance Form) performed by a physician, nurse practitioner or physician’s assistant within the previous three years, and
1.2 One of the following annual health questionnaires signed by a parent or guardian approving student participation in athletic activities:
1.2.1 Middle school students - District Procedure 604.4.1.1.2P, Middle School Annual Sports Health Questionnaire, Participation Release and Fees, or
1.2.2 High school students - Minnesota State High School League (MSHSL) Annual Sports Health Questionnaire.
2. Documentation to Resume Participation
After a student has major surgery, a serious illness or a serious injury, the attending physician must certify in writing the student's readiness to begin or resume participation in interscholastic athletics, danceline or cheerleading.