Injury Release 2

Injury Release 2

This form is to declare that the studio has conducted all necessary enquiries and confirms that each student is physically capable of undertaking the examinations.

It is compulsory that the studio submits this online form within the 48 hours before the exam start time, and no later than 2 hours before the exam start time. The Examiner cannot proceed with the examinations until this form has been submitted.

Supporting documentation, such as required medical reports, should be attached to verify a student's fitness for the examination if they do have an injury. It is recommended that medical reports not exceed 2 pages in length.

Studio Name*

Exam Plan Number*

Exam Date*

Examiner Name*

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Information provided

Details of any student presenting on exam day with known injuries. You must include the following;

Name of Student
Genre & Level the student will be participating in on exam day
Brief detail of Injury
Medical certificate or letter provided by medical practitioner to confirm they are fit to participate in the exam

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Please include any medical certificates, notes or letter provided by medical practitioner.

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Acknowledgement*

Today, I have made all the proper enquiries and confirm that each student is physically capable of undertaking examinations.

This form details any knowledge I have concerning physical injuries of a student and I have attached any supporting documents I have received from the student's medical practitioner.

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Form completed by (Registered Member)*

Date Completed:*

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