Get Your Sports Physical Early
Tuesday, July 13 and Thursday, July 22
5:30 - 8:30 p.m.
Capital Region Healthplex
1432 Southwest Blvd, Jefferson City, MO

Pre - registration and parental consent is required.
Open to athletes in grades 7 - 12

Call (573)632-5592 to schedule an appointment or register below

Registration Begins June 1
Range of Motion/Flexibility • General Exam
Orthopaedic Check (if needed) • Height/Weight • Blood Pressure
Please wear athletic attire to the exam
Cost: $20.00

The Registration allows for appointments every quarter of an hour. All information required.

REGISTRATION
Your Name
E-mail Address
Phone #
First Time Preference			--Select a Day-- Tues July 13 Thurs July 22 --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-- Tues July 13 Thurs July 22 --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.