Athletic Physical Day Registration
Athletic Physical Day is Thursday, May 1 from 4:30 - 6:30 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
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First Name
Last Name
Student Date of Birth
*
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Month
-
Day
Year
Date
Student Grade for 2025 - 2026 School Year
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Please Select
Freshman
Sophomore
Junior
Senior
Other
Intended Sport(s) for 2025 - 2026 School Year (Please check all that apply)
*
Cheer
Cross Country
Dance
Girls Flag Football
Football
Boys Golf
Girls Golf
Boys Tennis
Girls Tennis
Beach Volleyball
Boys Volleyball (Indoor)
Girls Volleyball (Indoor)
Boys Water Polo
Girls Water Polo
Boys Basketball
Girls Basketball
Boys Soccer
Girls Soccer
Hockey
Wrestling
Badminton
Baseball
Softball
E-Sports
Swim
Track & Field
Parent Name
*
First Name
Last 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
Submit
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