Developmental Baseball Forms

Please carefully read all of the following information before completing the necessary forms. All forms must be submitted by the due date in order to be eligible for participation on any DSC developmental team. Parents must complete and sign insurance forms if their son/daughter is covered under their policy. Parents must sign ALL forms for any athlete under 18 years of age.

ATHLETIC PHYSICAL EXAMINATION

All students wishing to participate on a developmental team must provide a physical exam conducted by a board-certified physician. Physical Exam forms may be printed from the DSC website (see below) and taken to a physician (M.D. or D.O.) to be completed.

PREVIOUS INJURIES

All student athletes must provide documentation from a physician regarding current and/or previous history of medical conditions, including concussion, cardiac incidents, surgeries, and other injuries. Written clearance from a medical doctor to participate in athletics, written on his/her letterhead, must be provided for any injury incurred within the last year for which a doctor was consulted. If you are currently under the care of a physician or undergoing physical therapy or rehabilitation for an injury, you must submit all paperwork associated with that injury. It is very important to submit ALL medical records as requested to avoid any delay in the eligibility process for team participation.

Students who have not been “cleared” by the physician conducting their exam may NOT play or practice with the team until requirements that are restricting the student are met. The final decision regarding participation in athletics resides with the Daytona State College Team Physician and Sports Medicine Staff.

INTERCOLLEGIATE ATHLETIC ACCIDENT INSURANCE COVERAGE

All students participating on DSC developmental sports teams must provide proof of health insurance which covers sports injuries. Daytona State College and the Athletic Department do not provide insurance coverage for developmental teams. Please be sure you are aware of your health insurance policies and procedures regarding deductibles and co-pays. Prospective student-athletes must have a completed Athlete Insurance Information form on file with the Office of Sports Medicine prior to any participation in team activities. Please complete all requested information in its entirety to avoid any delay in starting practices. You must also submit a copy of the front and back of all health insurance cards, including general medical, dental, and vision, if applicable. If the student-athlete’s insurance changes during the school year a new copy must be submitted.

We recommend that any athlete with a who resides more than 30-45 minutes away from Daytona Beach change his/her primary care physician to a local one, preferably Daytona State College’s primary care physician. This change will greatly lessen the amount of time, money, and energy spent on accessing appropriate health care, and therefore, time away from active sport participation. Please contact your insurance company to inform them that your son/daughter will be away at college.

The DSC Sports Medicine Department must receive any changes to a health insurance policy within 30 days of that change. If proper notification is not received, Daytona State College Athletics will not be responsible for any resulting delays in treatment, payment, collection notices, etc.

REQUIRED FORMS

All forms should be completed online, then printed and signed. You will not be able to save a completed document without printing and then scanning. 

The following forms are required:

» Medical History Questionnaire [PDF]

 

Send all forms via email or regular mail to:

Katy Jo Waltz, ATC, LAT
Daytona State College Athletics
1200 W. International Speedway Blvd.
Daytona Beach, FL 32120

Email: Kaitlyn.Waltz@DaytonaState.edu

Phone: 386-506-3114


» Physical Examination Form [PDF]
» Sickle Cell Trait Information and Waiver [PDF]
» Health Insurance Information [PDF]
» Photocopy of front and back of Insurance Card
» Health Information Disclosure Consent Form [PDF]