Welcome Student-Athletes & Parents!

The purpose of this page is to acquaint you with the pertinent and necessary athletic and medical information that you, as a member of any intercollegiate athletic team at Midway College (MC) including IHSA teams, will need to download, complete, and return to your respective coach at Midway College. On this page you can find all required Athletics Treatment Clinic (AT Clinic) medical and insurance paperwork as well as the policies and procedures relevant to the required forms. Please take some time to read through these documents.

All athletes must have the seven forms/documents listed below completed in full, on file in the AT Clinic, and processed by the Head Athletic Trainer prior to being able to participate in any team activity and athletic event. All printable forms require the use of Adobe Acrobat Reader. All Athletics Treatment paperwork is due by August 1, 2010. Please mail all of your forms to your respective coach at Midway College Athletics, 512 E. Stephens Street, Midway, KY 40347, failure to do so may result in a student-athlete being held out of practice and/or competitive events until the forms are properly completed and processed. Thank you for your time and attention to these details!

1. A completed medical history form & sport physical

New or Transfer athletes: Students who are new to athletic participation at Midway College are required to use the Athletics Treatment Medical History/Pre-participation Physical Exam Form to obtain a sport physical (more extensive than a general health physical) at your own expense from a medical doctor, physician assistant, or nurse practitioner prior to arrival on campus. Sport physicals must be done using the Midway College form below or will not be accepted. New student sport physicals must also be completed no earlier than June of the same calendar year for a student enrolling in August. If additional medical examination is required, it will be at the expense of the athlete. If you are an incoming first-year student, transfer student, or an upper-class student new to athletic competition at Midway College, download and return the completed form to your respective coach.

New Student-Athlete Pre-participation Medical History/Sport Physical Form

Returning athletes: You are required to obtain an updated sport physical at your own expense. Outside sport physicals must be done using the Midway College form below or will not be accepted. If you are a returning Midway student-athlete, download and return the completed form to your respective coach.

Returning Student-Athlete Medical History Update/Sport Physical Form

2. A completed insurance information form

Athletes are not allowed to participate without personal medical insurance coverage. All athletes must provide proof of a primary medical insurance plan which:
1) covers athletic participation & injuries without exclusion or reasonable limitation [the NAIA is responsible for coverage of injuries exceeding $25,000], and
2) carries no higher than a $2000 annual deductible (Note: Midway College recommends carrying no higher than a $1000 deductible).

If your daughter sustains an athletic related injury which results in a bill, please refer to the information below for pertinent information. If you have questions or need information regarding student-athlete primary insurance coverage requirements, payment of athletic-related medical bills, and the insurance claims process at Midway College, please click on following link:

Athletic Injury Treatment Policies & Procedures

The completed insurance information form should be returned to your respective coach.
Insurance Information Form

3. A front & back insurance card copy

All athletes must provide a clear, front & back copy of the student’s current medical insurance card to your respective coach.

4. A completed medical financial responsibility form

If your daughter sustains an athletic related injury which results in a bill, please refer to the information below for pertinent information. All Midway College students who participate in National Association of Intercollegiate Athletics (NAIA) and/or Intercollegiate Horse Show Association (IHSA) teams and competitions are responsible for all costs over $2,000 incurred for injuries as a result of participating in athletics either in practice or in competition. To read the full policy regarding student and/or parent medical financial responsibility, please click on the link below.

The completed medical financial responsibility form should be returned to your respective coach.

Medical Financial Responsibility Form

5. A completed medical consent form

The Health Insurance Portability and Accountability Act (HIPAA) describes how health information about students may be used, disclosed, and how students may gain access to their individually identifiable health information. If you have any questions regarding HIPAA, click on the link below for a copy of the Notice of Privacy Practices as required by the Privacy Regulations created as a result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Notice of Privacy Practices

The completed medical consent form should be returned to your respective coach.

Medical Consent Form

6. A completed drug & alcohol testing consent form

The use of illegal or banned substances within the NAIA represents a violation of the Champions of Character initiative, and is seen as a serious threat to the core character values. Student athletes need to be aware that the use of banned substances not only represents a violation of the Champions of Character student athlete pledge but a violation of institutional policy. Student athletes also need to be aware of the consequences surrounding the use of banned substances not only personally (physical, emotional, social) but that their use can be detrimental to both team and individual sport success. Midway College Athletics has a random drug testing policy which is administered a minimum of once per semester. All athletes are subject to random testing whether in or out of their sport season.

To read the full policy regarding Midway College Athletic Department’s drug & alcohol policies, testing procedures, and violation sanctions, please click on the following link:

Athletics Drug & Alcohol Policy
The completed drug & alcohol testing consent form should be returned to your respective coach.

Athletics Drug & Alcohol Testing Consent Form

-Please return together all completed forms/documents to your respective coach.
-This information must be mailed to your respective coach.
-If you have any questions regarding the required material, please e-mail (preferred) or call your coach or the Athletic Director.

7. A completes Student-Athlete Concussion Statement

All athletes must read the NCAA Concussion Fact Sheet for Student-Athletes and then fill out the Student-Athlete Concussion Statement.

Other Helpful Information

Athletics Treatment Clinic Policies & Procedures
Sports Medicine Staff and Team Physicians
Midway College Mouth Guard Policy
AT Equipment Care & Return Instructions

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