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20212022 Iowa Application for Free & Reduced Price School Meals/MilkReturn completed form to: Keeper Catholic School 116 S East Street Carroll, IA 51401Complete one application per household. Please
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Make sure to read all instructions carefully before filling out the form.
02
Provide accurate personal information including name, date of birth, address, and contact information.
03
List any medical conditions, allergies, or previous injuries you have experienced.
04
Include information about any current medications you are taking.
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If applicable, provide details about your primary care physician and any specialist you may be seeing.
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Be sure to sign and date the form once you have completed it.

Who needs preparticipation physical form-0912?

01
Athletes participating in school sports programs.
02
Individuals enrolling in a fitness program or gym.
03
Military personnel undergoing physical training.
04
Participants in recreational sports leagues.
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The preparticipation physical form-0912 is a medical document that evaluates an individual's health status before participating in sports or physical activities, ensuring they meet the health requirements for safe participation.
All student-athletes wishing to participate in school-sponsored sports programs must file the preparticipation physical form-0912.
To fill out the preparticipation physical form-0912, individuals must provide personal information, medical history, and details about any previous injuries, and have a licensed healthcare professional complete the physical assessment.
The purpose of preparticipation physical form-0912 is to assess the physical readiness of athletes, identify any health concerns, and prevent injuries during athletic participation.
The form must report personal information, medical history, any ongoing medical conditions, medications, allergies, physical examination findings, and clearance status from a healthcare provider.
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