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Summer 2023 Physical Clinic Registration
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* Indicates required question
Email
*
Your email
Name of Parent /Legal Guardian
*
Your answer
Please choose form the following 2 dates which clinic you would prefer to attend.
*
Saturday, June 10th 9AM - 12Noon
Saturday, July 29th 9AM - 12Noon
Required
Number of Student athletes/band members you are in need of receiving a physical
*
1
2
3
4
5
6
Name of student athlete /band member #1
*
Your answer
Name of student athlete/band member #2
Your answer
Name of student athlete/band member #3
Your answer
Name of student athlete/band member #4
Your answer
Name of student athlete/band member #5
Your answer
Name of student athlete/band member #6
Your answer
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