Field Work:

Students need to fill out this form and turn it in to me

after completing event coverage

Student Name: __________________________________

Attended: Collision/Contact Sports: Football W Soccer W Basketball

M Basketball Wrestling M Soccer

Limited Contact Sports: Baseball Softball Volleyball

Non-Contact Sports: M Golf W Golf Cross country Track

Swimming M Tennis W Tennis Field Events

Event: Game Practice

Event Date: _______Time Began:_______Time Ended:_______Total Hours:____

Coach/Administrator Contacted:__________________________

Activities Involved: ____________________________________

____________________________________________________

____________________________________________________

Injuries: ____________________________________________

____________________________________________________

____________________________________________________

Any injury Management? ________________________________

____________________________________________________

____________________________________________________

Evaluation Form Distributed/Signed? Yes no

Please turn in your evaluation form, complete with this form. The evaluation form should be signed and filled out by the coach, a school administrator, or Dr. Parris.

The above is true and accurate to the best of my knowledge.

_________________________________ ____________

Student Signature Date