coverletter by HC121003191611


									Dear Parents,

The athletic staff is pleased to have your son/daughter as a student-athlete at the University of
Wisconsin-Platteville. We are hopeful that the opportunity presented here at UWP will be a
rewarding experience and that he/she will achieve academic, social, and athletic success.

Please review the following instructions to complete the forms required for athletic participation.
Each form must be completed and submitted to the athletic office or athletic training room prior
to your son/daughter’s participation in any practice or competition. All forms must be returned
by August 1st. Student-athletes who submit any forms after Aug. 1st will be charged a $20.00 late
fee. Late fees must be paid prior to any participation in athletic activities. Please submit the
following forms:

    1. ______ Physical Examination Form
        Each student-athlete is required to provide a medical history, current physical
        examination, and medical clearance prior to intercollegiate athletics participation. The
        physical exam must be completed and signed by a licensed physician. Physicians may
        authorize Nurse Practitioners or physician Assistants to stamp this form with the
        physician’s signature or name of clinic with which the physician is affiliated.

    2. ______ Insurance Information Form
        ♦Attention♦ Please note that all NCAA Division III student-athletes must provide
        evidence of insurance that must have coverage of at least $90,000 which includes
        coverage for athletically related injuries. This is a pre-requisite for all athletic activities
        including practice and competition. No student will be allowed to participate in any
        activities until such evidence of current insurance is on file with the UWP department of
        athletics. If you have questions regarding the terms of your coverage, you should contact
        your insurer immediately. Please be sure to note if there are any exclusions in your policy
        regarding athletically related injuries.

    3. ______ Photocopy of medical insurance card (front & back)
        The accompanying insurance form and insurance card (photocopy of both sides), must be
        on file before a student is allowed to participate.

Thank you for your cooperation. Any correspondence regarding these forms or athletic injuries
should be addressed to: Athletic Training Room, University of Wisconsin-Platteville, 022
Williams Fieldhouse, 1University Plaza, Platteville, WI 53818.

 Please contact the athletic training staff or main athletic office if you have any questions or


Scott Soja, M.Ed., ATC, CSCS
Head Athletic Trainer

                                                                                         Revised 2011

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