WLB Athletics - Spring Season Sign-Up, Handbook and Related Forms Sign-Off
Please complete the follow registration to participate in Spring athletics.

In order to participate in interscholastic athletes at FAS, an updated or current physical must be approved by the school nurse. Please visit the school nurse's website for additional information. FAS Physical Form can be located here: https://www.wlbschools.com/cms/lib/NJ01001458/Centricity/Domain/38/Physical%20Form.pdf

If you have any questions, please contact the coach or Mr. Castagno, Student Activities Director

Sign in to Google to save your progress. Learn more
Email *
Athlete's Name (Full First and Last Name) *
Athlete's Grade *
Has a physical been submitted to the school nurse? *
If available, list the date of the most recent physical
MM
/
DD
/
YYYY
Fall Sport Selection *
Required
Athletic Guides and Related Forms
Please read the athletic guidelines and complete the information below.
Athletic Guidelines
Athletics Guidelines Sign Off - Player Name (digital signature) *
Athletics Guidelines Sign Off - Parent/Guardian (digital signature) *
Sports-Related Concussion and Head Injury Fact Sheet - Player Name (digital signature) *
Sports-Related Concussion and Head Injury Fact Sheet - Parent/Guardian (digital signature) *
Opioid Use and Misuse Educational Fact Sheet - Player Name (digital signature) *
Opioid Use and Misuse Educational Fact Sheet - Parent/Guardian (digital signature) *
Student Cardiac Death in Youth Athletes - Player Name (digital signature) *
Student Cardiac Death in Youth Athletes - Parent/Guardian (digital signature) *
Date Form was completed and of digital signatures *
MM
/
DD
/
YYYY
Health History Questionnaire
Please complete the following New Jersey Department of Education - Health History Update Questionnaire. To participate on a school-sponsored interscholastic or intramural athletic team or squad, each student whose physical examination was completed more than 90 prior to the first day of official practice shall provide a health history update questionnaire completed and signed by the student's parent or guardian.
Since the last pre-participation physical examination, has your son/daughter been medically advised not to participate in a sport? *
If Yes, describe in detail
Since the last pre-participation physical examination, has your son/daughter sustained a concussion, been unconscious or lost memory from a blow to the head? *
If Yes, describe in detail
Since the last pre-participation physical examination, has your son/daughter broken a bone or sprained/dislocated any muscle or joint? *
If Yes, describe in detail
Since the last pre-participation physical examination, has your son/daughter fainted or "blacked out"? *
If Yes, was this during or immediately after exercise?
Since the last pre-participation physical examination, has your son/daughter experienced chest pain, shortness of breath or "racing heart"? *
If Yes, explain
Since the last pre-participation physical examination, has you son/daughter been hospitalized or had to go the emergency room? *
If yes, explain in detail
Since the last physical examination, has there been a sudden death in the family or has any member of the family under age 50 had a heart attach or "heart trouble?" *
Has your son/daughter started or stopped taking any over-the-counter or prescribed medications? *
Has your son/daughter been diagnosed with Coronavirus (Covid-19)? *
If diagnosed with Coronavirus (Covid-19), was your son/daughter symptomatic?
Clear selection
If diagnosed with Coronavirus (Covid-19), was your son/daughter hospitalized?
Clear selection
Has any member of the student-athlete's household been diagnosed with Coronavirus (Covid-19) *
Date the Questionnaire was completed *
MM
/
DD
/
YYYY
Digital Signature of Parent/Guardian for the Questionnaire *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of West Long Branch Schools. Report Abuse
Google Forms