SUMMER PHYSICAL

Don’t Miss Out - ONE DAY ONLY!!!!

2008-2009 High School & Middle School Athletic Physicals

Saturday August 2, 2008 

8:00 a.m. – 12:00 p.m. (D-11 is asked to come between 10 a.m. and 12 p.m. if possible)

Cost is $20.00

NO Appointment Needed, But Registration is Required!

Sponsored By Colorado Springs Orthopedic Group,

Mountain View Medical Group & Colorado Sports & Spine Centers at: 

CSOG Audubon Medical Campus

3010 N. Circle Drive Suite 100

Colorado Springs, CO 80909

Please fax this form to 574-7509 or e-mail us at info@csog.net or call

572-0679 to register. District 11 students are expected to arrive between

10am – 12pm. Download the sports physical form at www.csog.net and bring

it with you.

Athletes Name:                                                               

Phone:                                                                                 

School:                                                                    

*Payment is due at time of service, cash or checks only.   Students MUST be accompanied by their Parent or Legal Guardian. High school and middle school only-NO elementary students.  Any students previously diagnosed with asthma, heart conditions or head injuries (past two years) MUST SEE their regular physician for their sports physical.