GET ON THE BALL

Sports Physicals - 7th through 12th grades
Thursday, July 11 and Tuesday, July 23
5:30 - 8:30 p.m.

Capital Region Sam B. Cook Healthplex
1432 Southwest Boulevard, Jefferson City, MO

Pre-registration and parental consent required.
Call (573) 644-7878 for an appointment or sign up below.
Registration begins June 1.

Height/Weight - Blood pressure
Range of Motion/Flexibility - General Exam - Orthopaedic Check (if needed)

Please wear athletic attire to the exam.
Cost: $25.00

The $25.00 fee helps to defer the direct cost of providing the program.

Click Here to Download and print the Pre-participation Evaluation Form
You may fill out the form and bring it with you to your appointment.

The Registration allows All information required.

REGISTRATION
Your Name
E-mail Address
Phone #
First Time Preference			--Select a Day-- Thurs July 11 Tues Juley 23 --Select a Time-- 5:30 pm 5:45 pm 6:00 pm 6:15 pm 6:30 pm 6:45 pm 7:00 pm 7:15 pm 7:30 pm 7:45 pm 8:00 pm 8:15 pm
Second Time Preference			--Select a Day-- Thurs July 11 Tues Juley 23 --Select a Time-- 5:30 pm 5:45 pm 6:00 pm 6:15 pm 6:30 pm 6:45 pm 7:00 pm 7:15 pm 7:30 pm 7:45 pm 8:00 pm 8:15 pm
You will be contacted if your selected time(s) is not available.