MONROE TOWNSHIP PUBLIC SCHOOLS Monroe Township Middle School 1629 Perrineville Road • Monroe Township, NJ 08831 Telephone (732) 521-6042 Fax (732) 521-3129 E-mail www.monroe.k12.nj.us Chari Chanley, Ed.S. James Higgins Scott Sidler Principal Assistant Principal Assistant Principal October 1, 2012 Dear Parent/ Guardian, All students interested in participating in a winter sports team must have a sports physical. Your daughter/son must have a health questionnaire (part A), physical exam form (part B), and parental consent form completed and on file in the nurse’s office prior to trying out for any school sport. It is not necessary for middle school parents to fill out and sign the Steroid Testing Consent Form. If your child has a physical on file in the nurse’s office and it is current (can’t be older than 365 days from the date of the first try out) this will satisfy the requirement of a physical exam. If a patent/guardian chooses to take their child to their own physician they must obtain the above mentioned documents and take them at the time of the physical to their doctor. The doctor must sign that they have read Part A Health History Questionnaire. All physicals must be completed to include vision screening. Any physical not completed will be returned to the family. Students may receive physicals from either their private physician or by the school doctor. Every student going out for a winter 2012-2013 sport must have a physical either by our school physician or by their own physician on or before Tuesday, October 30, 2012. The school physician will be available for physical appointments on Tuesday, October 23, 2012 & Tuesday, October 30, 2012. Physicals will take place at the Monroe Township Middle School Nurse’s Office during school hours. There is no charge to receive a physical by the school physician. Any student that does not receive a physical by the school physician on the above mentioned dates is responsible to receive a physical by their private physician. In order to participate for a winter sport, ALL paper work is due in the MTMS nurse’s office no later than Thursday, November 1, 2012. Please remember that if your child handed in paperwork to participate in tryouts for the fall 2012 season they must still hand in updated paperwork (health questionnaire – part A & a parental consent form) to the nurse’s office by Thursday, November, 1, 2012 All pre-participation, parental consent and physical forms are available on the Monroe Township High School website under the athletics link and in the high school and middle school nurse’s office. Please make sure all forms are signed prior to the physical date. To schedule an appointment, please contact Mrs. Dowd or Mrs. Torrillo at 732-521-6042 Ext. 2004 or e-mail them@ Deborah.email@example.com or Shirley.firstname.lastname@example.org. Sincerely, Deborah Dowd Shirley Torrillo Cheryl Whinna Deborah Dowd, RN Shirley Torrillo, RN Cheryl Whinna MTMS School Nurse MTMS School Nurse MTMS Athletic Coordinator SUCCESS IS ALWAYS A TEAM EFFORT!!
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