Eight Quarter Pre-Participation Form
February 2021
Instructions:
1. Before every contest, complete and send copy to Conference Administrator.
2. After the contest, if student played, upload to Home Campus Eight Quarter Follow-Up Form.
School:
Classification:
Conference:
Scheduled Date of Game:
Player’s Name:
_____________________________________________________ has been designated as an
emergency player and can participate in a Junior Varsity and Varsity football game scheduled
in the same week.
***Once a player has used all of their allotted 8-quarters, they must be designated as
JV or Varsity for the remainder of the regular season***
My signature below indicates that I grant my permission for the above
player to participate in the scheduled varsity football game.
Parent/Legal Custodian: _______________________________________________ Date: ___________________
(Signature)
Date:
(Signature)
Date:
(Signature)
MEDICAL EVALUATION
Urine Specific Gravity (USG):
Hydration Assessment Results for
Eight Quarter Participation Eligibility
If USG reading unavailable:
Condition
% Body Mass
Change
Urine Specific
Gravity
Pre-game weight Thursday
Lbs.
Acceptably
Hydrated
< -3
< 1.021
Post-game weight Thursday
Lbs.
Pre-game weight Friday
Lbs.
% Body mass change
%
HYDRATION TEST: PASS FAIL MUSCULOSKETETAL SCREEN: PASS FAIL
*******************************************************************************************
MEDICAL STATEMENT
I,
,MD
DO
LAT
PA
NP
have examined the above player following participation in the junior varsity football game on Thursday and find
him/her acceptably hydrated and void of any injury that would render him/her unfit to play.
Signature:
Date:
(USG can be evaluated any time after the conclusion of the JV contest and prior to the start of t
he Varsity contest.)