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Submit this form prior to participating. No other forms are acceptable. Every Pop Warner Association must have a fully completed and signed original of this form prior to allowing the athlete to participate.

Medical history

Section I must still be filled out entirely and attached to any modified / substituted form. Section III must be completed in its entirety ONLY by a licensed State Examiner (medical doctor, nurse practitioner). 


Volunteers must comply with Section 1, Article 4, Proprietary RIghts, of the policies and procedures of Pop Warner Little Scholars, Inc. Any violation may result in revocation of the league charter. 

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