GATEWAY REGIONAL HIGH SCHOOL
DEPARTMENT OF ATHLETICS/ACTIVITIES
775 Tanyard Road
Woodbury Heights, New Jersey 08097
(856) 848-8200
Dear Parents/Guardians:
In accordance with Scholastic Student–Athlete Safety Act P.L. 2013, c.71, prior to participation on a school-sponsored interscholastic or intramural athletic team or squad, each student-athlete in grades 6 through 12 must present a completed pre-participation physical evaluation (PPE) form to the designated school staff member. Important information regarding the PPE is provided below, and you should feel free to share with your child’s medical home health care provider.
1. The PPE may ONLY be completed by a licensed physician, advanced practice nurse (APN) or physician assistant (PA) that has completed the Student-Athlete Cardiac Assessment professional development module. It is recommended that you verify that your medical provider has completed this module before scheduling an appointment for a PPE.
2. The required PPE must be conducted within 365 days prior to the first official practice in an athletic season.
3. The parent/guardian must complete the History Form, and insert the date of the required physical examination at the top of the page.
4. The parent/guardian must complete The Athlete with Special Needs: Supplemental History Form, if applicable, for a student with a disability that limits major life activities, and insert the date of the required physical examination on the top of the page.
5. The licensed physician, APN or PA who performs the physical examination must complete the remaining two pages of the PPE, and insert the date of the examination on the Physical Examination Form and Clearance Form.
6. The school district must provide written notification to the parent/guardian, signed by the school physician, indicating approval of the student’s participation in a school-sponsored interscholastic or intramural athletic team or squad-based upon review of the medical report, or must provide the reason(s) for the disapproval of the student’s participation.
7. For student-athletes that had a medical examination completed more than 90 days prior to the first official practice in an athletic season, the Health History Update Questionnaire (HHQ) form must be completed, and signed by the student’s parent/guardian. The HHQ must be reviewed by the school nurse and, if applicable, the school’s athletic trainer.
The PPE and HHQ forms are available via Gateway Regional High School’s online sports registration page. Please refer to the Online Registration-Quick Reference Guide section below for specific directions.
Additional Medical Information:
Please return all medical forms to GRHS on or prior to the due dates listed below. This will allow our school nurse and the school physician time to review all paperwork, so that your child will be eligible to participate in the first official practice of the season. Failure to return all necessary documents by the due dates listed below could delay your child’s ability to start practicing on the first day of official practice. We recommend that you make an appointment for a physical examination as soon as possible, if necessary
Paperwork Due Dates
Winter
Online Registration-Quick Reference Guide
*If you have registered your child previously, go to the Login link, located at bottom of the screen on the blue bar.
*In order for your child to be cleared to participate in athletics both the physical forms and online registration needs to be completed.
Any questions, problems or issues with the online registration portion, please contact Athletic Director Mike DiCicco.
In my daughters' quest to participate in college athletics, NCSA has given them exposure to colleges and coaches they otherwise would not have had. -Chriss Broussard, Fox Sports Analyst & NCSA Parent