My signature indicates that the medical history information provided on this form is accurate and complete. At any time, I can request via email (siucompsports@siu.edu) that my medical history information is immediately discarded.
My signature verifies that (a) I am a currently enrolled SIU Student that has paid the General Student Fee, (b) a currently enrolled SIU Student that has purchased the inactive student membership, or (c) a current RSS member that is at least eighteen years of age and has purchased a semester or annual membership.