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23 - 24 NBHS Weight room Questionnaire
Anyone interested in using the weight room must:
complete this questionnaire.
have a valid physical on file at the NBHS. Physicals can be turned into the Athletic Office.
YOU ONLY NEED TO COMPLETE THIS FORM ONCE
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* Indicates required question
Name
*
Your answer
ID#
Your answer
Grade (2023 - 2024)
*
9
10
11
12
Date of Birth
*
MM
/
DD
/
YYYY
Activity
*
weightroom
Leave blank (for internal purpose only)
Option 1
Clear selection
Leave blank (for internal purpose only)
Option 1
Clear selection
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Option 1
Clear selection
Gender
*
Male
Female
Parent Name
*
Your answer
Parent Cell #
*
Your answer
Parent email
*
Your answer
Does your son/daughter have any pre-exisiting medical conditions or are immunocompromised(such as diabetes, asthma, auto-immune disorders, etc.)?
*
yes
no
If yes, what condition?
Your answer
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