Authorization for the Release of Medical Information
In order for a student to participate in the We Run Our Community’s Kids (WeROCK) marathon training program, he/she must have a current Physical Screening & Physician Authorization Form (the Form) on file in the WeROCK office. The Form must include approval from a licensed physician for the student to participate in the program and must indicate that the physician completed a physical examination of the student within the most recent 30 days. The deadline for submitting the Form to the WeROCK office is November 9, 2018. Students without the Form on file as of this date will not be allowed to continue with the program for the remainder of the 2018-2019 season.
In order for the Physical Screening & Physician Authorization Form to be acceptable, the Form must be completed, in its entirety, by the parent/guardian and by the licensed physician, and must include the date of the examination, the physician’s signature, and a stamp from the doctor’s office or clinic where the examination was completed.
WeROCK also strongly recommends that all participants have an EKG test completed prior to participation in the marathon training program. Completion of an EKG will be left to the decision of the parent/guardian of the participant, and to the participant’s licensed physician, with the physician advising the parent/guardian on the risks of participating in the program without an EKG being completed.
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