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Activity Forms

2018-2019 Activities Participation

ATTENTION parents and athletes entering Grades 7-12 as well as those entering Grade 6 that plan to participate in Cross Country or Wrestling! 

The South Dakota High School Activities Association (SDHSAA) and the Harrisburg School District require certification as to the adequacy of a student’s health for athletic participation. 

  • This certification shall be restricted to a duly licensed doctor of medicine, doctor of osteopathy, doctor of chiropractic, licensed physician’s assistant or licensed nurse practitioner. 
  • All exams must be signed by authorized medical personnel as listed above.
  • Stamping the name of a medical clinic or a medical association as a substitute for the Doctor’s signature is unacceptable.
  • Physicals taken in the spring for the ensuing school term shall be taken after April 1.  
    • For example, a physical taken on April 1, 2018 is valid for the 2018-19 school year.  
    • A physical taken on March 1, 2018 expires on July 1, 2018 and is NOT valid for the 2018-19 school year.

To meet the requirements of the SDHSAA and the District, please follow the steps below.  Once all steps are complete you are cleared to participate.  Again, this process MUST be completed and forms MUST be submitted to the HIGH SCHOOL ACTIVITIES OFFICE prior to the first day of your sport’s season. 

 

CLICK HERE FOR SEASON START DATES AND MEETING DATES!!

Please complete these Steps prior to the first day of practice to be cleared to participate in your activity!

Step 1:  Athletes fill out the Preparticipation Physical Evaluation HISTORY FORM.  Take the HISTORY FORM and the SDHSAA PHYSICAL EXAMINATION FORM  to an authorized medical provider (listed above) for a physical exam.  Download these forms HERE.

Step 2: Athletes and Parents fill out the Parental and Student Medical Consent and Concussion Awareness Forms required by the SDHSAA and the District.  Download these forms HERE.    

Step 3:  Once you have you have completed Steps 1 & 2, you may submit the forms in one of two ways.

  1. Turn in ALL forms to the Harrisburg High School Office. (DO NOT turn forms in to any Middle School or Elementary School Office!)
  2. E-mail an electronic copy of ALL forms to Jane Klemme at jane.klemme@k12.sd.us.

INCOMPLETE MATERIAL WILL NOT BE ACCEPTED, MAKE SURE THE ENTIRE PACKET IS COMPLETE.