Athletic Physical Day Registration

Athletic Physical Day Registration

Athletic Physical Day is Wednesday, May 1 from 4:30 - 7:00 PM. Please complete this registration form prior to arriving for Athletic Physical Day and ensure you have completed the Physical Forms on the Xavier website under Athletics > Athletic Clearance as well as register on www.athleticclearance.com. Walk ins are welcome. With any questions on Athletic Physicals, please contact our Athletic Trainer, Evan Buckley, at ebuckley@xavierprep.org - thank you!
Student Name*

First NameLast Name
Student Date of Birth*

MonthDayYear
Date
Student Grade for 2024 - 2025 School Year*
Intended Sport(s) for 2024 - 2025 School Year (Please check all that apply)*

CheerCross CountryDanceFootballBoys GolfGirls GolfBoys TennisGirls TennisBeach VolleyballBoys Volleyball (Indoor)Girls Volleyball (Indoor)Boys Water PoloGirls Water PoloBoys BasketballGirls BasketballBoys SoccerGirls SoccerWrestlingBadmintonBaseballSoftballE-SportsSwimTrack & Field
Parent Name*

First NameLast Name
Parent Email*
example@example.com
I am aware that this is simply a registration form for Athletic Physical Day on May 1 at Xavier College Prep. I agree to complete both the Physical Form and register at www.athleticclearance.com before I am able to receive my physical.*

I agree
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