- Roxbury Public Schools
- Health Forms
Health Forms for Student-Athletes
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Click to review Letter from the Director of Athletics
Dear Parent(s)/Guardian(s):
Congratulations on making the commitment to participate in Roxbury Township School District's Athletic Programs. These programs have a tradition of excellence and teach many valuable lifelong lessons. Please understand that successful participation will require a high level of dedication, responsibility, and diligence. We hope that all participants have a positive and rewarding interscholastic experience.
New Jersey State Law mandates that the school physician must check all sports physicals and sign the physical form prior to a student participating on any athletic team. No student will be allowed to participate in interscholastic sports (including tryouts and practices) until the school physician has signed the student's new physical exam form.
It is imperative then that all of the paperwork and forms explained on this webpage are completed and returned in a timely manner to ensure approval and eligibility for sports participation. Late submission will result in participation penalties; please see below on this webpage an outline of these consequences.We look forward to the upcoming athletic seasons and wish all students, advisors, coaches, and parents/guardians the best of luck for a successful and healthy season. If you do not have a medical home or if you have a question regarding the sports medical clearance process, please do not hesitate to contact my office at 973-584-1200 ext. 1230.
Sincerely,
Stuart Mason
Director of Athletics and Student Activities
Deadlines
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All paperwork and forms outlined below on this webpage must be completed no later than the dates indicated in the following table to ensure approval and eligibility for participation:
School Year Sports Season Due Date for Forms 2024/25 Fall July 12, 2024 (Fri) 2024/25 Winter Oct 25, 2024 (Fri) 2024/25 Spring Feb TBD, 2025
Physical Packet
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According to New Jersey State Mandates, each candidate who wishes to participate in athletics, school athletic squad, or a team MUST be examined by their primary health care provider within 365 days PRIOR to the first try-out or practice session. The date of your child's last physical exam can be verified in Genesis Parent Portal by clicking the documents tab and clicking physical exam status notification.
IMPORTANT - CLICK HERE FIRST before submitting a New Physical Packet
NEW PHYSICAL PACKET (English) (Spanish) - If a student needs a new physical, the following forms must be completed and returned to the health office:
- Health History Form completed by parent and submitted to health care provider
- Athletic pre-participation physical exam form completed by health care provider
- Medical Eligibility Form completed by health care provider and turned into the school
RECHECK PACKET (English) (Spanish) - If a student already has a valid physical cleared by the school physician and on file with the school health office, the following forms must be completed EACH NEW SPORTS SEASON and returned to the health office:- Health History Update Questionnaire completed by parent and turned into the school
Medication Packet(s)
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Any student athlete with asthma or a food/insect sting allergy that has/or has had an "Asthma Action Plan" or an "Anaphylaxis Action Plan" MUST also submit the appropriate Medication Packet below along with the “New Physical Packet” or the “Recheck Packet”, if it is not already on file with the health office for the current year, in order to be eligible for play.
Online Forms in Genesis
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Below are forms to be completed online in the Genesis Parent Portal for sports participation once prior to the start of the school year. These forms for the 2024/2025 school year will be available in Genesis beginning in July 2024:
- REMINDER: You must sign up for your sport each season in Genesis, once the form is available.
- Acknowledgement Form in Genesis for: Sudden Cardiac Death- To be completed by parent and student in Genesis after reviewing this pamphlet. (This pamphlet must be distributed to each student-athlete and to the parents/guardians of the student-athletes, pursuant to N.J.S.A. 18A:40-41c-d.)
- Acknowledgement Form in Genesis for: Athletic Training / Sports Injury Policies and Procedures- To be completed by parent and student in Genesis after reviewing this handout.
- Acknowledgement Form in Genesis for: Steroids Protocols, Consent Form and Banned Substances Information- To be completed by parent and student in Genesis after reviewing these correspondences from the NJSIAA.
- Acknowledgement Form in Genesis for: Sports-Related Concussion and Head Injury Facts- To be completed by parent and student in Genesis after reviewing this handout. (N.J.S.A. 18A:40-41.2 requires public schools to distribute an annual educational fact sheet on sports-related concussion and head injury to the parents/guardians of students participating in inter-scholastic sports and cheerleading, and to obtain a signed receipt.)
- Consent form in Genesis for: ImPACT- To be completed by parent and student in Genesis after reviewing this letter. (N.J.S.A. 18A:40-41.3 requires each school district that participates in interscholastic athletics to have a policy concerning the prevention and treatment of sports-related concussions and other head injuries among student-athletes.)
- Acknowledgement Form in Genesis for: Sports-Related Eye Injury Facts- To be completed by parent and student in Genesis after reviewing this fact sheet. (N.J.S.A. 18A: 40-41.9b requires this educational fact sheet on sports-related eye injuries to be distributed annually by each school district and nonpublic school to the parents/guardians of its student-athletes.)
- Acknowledgement Form in Genesis for: Opioid Use and Misuse Fact Sheet- To be completed by parent and student in Genesis after reviewing this letter and fact sheet. (N.J.S.A. 18A: 40-41.10 requires this educational fact sheet on opioid use and misuse to be distributed annually by each school district and nonpublic school to the parents/guardians of its student-athletes and cheerleaders; and for each school district and nonpublic school to collect parent/student acknowledgement of the form prior to the student's first official practice of the school year. For an Accessible Text-Only Version of the Opioid Use and Misuse Educational Fact Sheet, click here.)
- REMINDER: You must sign up for your sport each season in Genesis, once the form is available.
REMINDER: Late Submission Penalties
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Sport physical forms that are submitted after the due date will be subject to the following consequences:
- Within the first school week of due date:
Athlete will NOT be allowed to participate in his/her sport for 1 DAY after he/she has been cleared to participate. - Within the second school week of due date:
Athlete will NOT be allowed to participate in his/her sport for 2 DAYS after he/she has been cleared to participate. - Within the third school week of due date:
Athlete will NOT be allowed to participate in his/her sport for 1 WEEK after he/she has been cleared to participate. - Within four or more school weeks of due date:
Athlete will NOT be allowed to participate in his/her sport for 2 WEEKS after he/she has been cleared to participate.
- In accordance with NJ State Law, the school physician has been contracted by our Board of Education to visit our school 3 times per pre-season.
- The sole purpose for each of these visits is to review and sign off new sports physicals. This does not include already existing valid sports physicals on file in the health office.
- These 3 visits generally fall within the 4 week time frame of the stated due dates. Therefore, if new physical forms are turned in later than the last contractual visit made by our school physician, it will be the athlete's responsibility to incur any additional costs should another visit by the school physician be required to clear those forms submitted after the deadline.
- Within the first school week of due date: