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Athletics Health and Safety Plan - 09/21/20 

PK-12 Preseason Athletics Summary Page - 07/10/20

PK-12 Preseason Athletics Health and Safety Plan - 07/09/20

To be eligible to try out for any sport, each student-athlete is required to have a PIAA Comprehensive Initial Pre-Participation Physical Evaluation (CIPPE) form completed. The form must be dated June 1, 2020, or after. 

Sections 1-6 and Section 10, must be completed by all athletes. No student-athlete is allowed to tryout for any sport until all appropriate sections have been completed. Please read below to see if you need to turn in Section 7 or Section 8. Please remember that all dates for tryouts are fluid, and we will continue to keep you updated in our weekly Friday email from Mr. Donaghy. 

Link to the PIAA CIPPE: http://www.piaa.org/assets/web/documents/PIAA_CIPPE_FORMS_SECTION(S)_1_-_10(1).pdf

Section 1- Personal and Emergency Information, completed by parent/guardian

Section 2- Certification of Parent/Guardian, completed by parent/guardian

Section 3- Understanding of Risk of Concussion and Traumatic Brain Injury, completed by parent/guardian and student-athlete

Section 4- Understanding of Sudden Cardiac Arrest Symptoms and Warning Signs, completed by parent/guardian and student-athlete

Section 5- Health History, completed by parent/guardian and student-athlete

Section 6- PIAA Comprehensive Initial Pre-Participation Physical Evaluation and Certification of Authorized Medical Examiner, completed by MD, DO, PAC, CRNP, or SNP

Section 10- 2020-2021 Supplemental Acknowledgment, Waiver and Release: COVID-19, completed by parent/guardian and student-athlete

If you played a fall sport or turned in a physical packet dated October 19 or earlier, you need to complete the following: 

Section 7- Re-Certification by Parent/Guardian, completed by parent/guardian and student-athlete

This form must be completed for any student who, subsequent to completion of sections 1-6 of the CIPPE form, required medical treatment from a licensed physician or osteopathic medicine: 

Section 8 - Re-Certification by Licensed Physician of Medicine or Osteopathic Medicine 

If you have any questions about your physical form status, please contact our athletic trainer, Ms. Katie Young, at kyoung@premierortho.com or kyoung@haverfordsd.net

Additional Required Forms:

Assumption of Risk

Eligibility Form

Impact Permission Form (9th Grade, 11th Grade, New Students)

Student Contract

COIVD-19 Athletics Parent/Guardian Checklist & Signature

The CENTRAL LEAGUE provides students the opportunity to develop skills in an educational setting. Please give these students your positive encouragement and support.  The Central League partners with the PIAA in supporting our Student Athletes through application of all PIAA Rules.  Parents are welcome to visit the PIAA website to explore these expectations.