Forms for Athletes

Student-athletes and parents,

Welcome to Dordt athletics! Our athletic training staff consists of two nationally certified and licensed athletic trainers in the state of Iowa. We work with the Sioux Center Community Hospital and the surrounding medical community to ensure safe participation in athletics. We are here to help you with whatever your needs may be, feel free to contact us at any time.

Chris Fagerness, head athletic trainer, ATC, LAT, NASM-CES
Email: dordtatc@dordt.edu
Office Phone: (712) 722-6312
Cell Phone: (605) 421-9835

This page outlines the required athletic and medical information you will need as a member of any intercollegiate athletic team at Dordt.

All athletes must have the following forms completed prior to practicing or competing for any athletic team at Dordt.

  1. A completed physical form

    All athletes at Dordt must complete a physical form prior to each academic school year. Returning athletes have the opportunity to have these physicals performed at the conclusion of the second semester while incoming first-year athletes must have the form completed prior to arriving on campus in the fall.

  2. A completed proof of insurance form

    All athletes must provide proof of a primary insurance plan that covers athletic injuries. Athletes cannot participate in practice or competition without insurance coverage.

  3. A completed athletic injury procedure and secondary insurance form

    Dordt has a sports accident insurance policy that covers athletic injuries. It will only cover expenses not covered by your primary insurance carrier. Dordt requires that you have acceptable primary insurance to participate in athletics, and you must follow all procedures required by your insurance carrier and Dordt.

  4. A personal information form

    The Dordt athletic training staff must have personal information and contact information on file for all athletes before they participate in practice or competition.

  5. A completed HIPAA form

    The Health Insurance Portability and Accountability Act (HIPAA) describes how student health information may be used and disclosed and how students may get access to their individually identifiable health information.

  6. A. A consent to participate in random drug testing program form

All athletes who participate in athletics at Dordt must submit to Dordt's random drug testing program. This helps to ensure safe participation among all Dordt athletes.

B. A consent to release information form (optional)

This form gives consent to Dordt to share information regarding any random drug test results to parents or guardians. This form is not required for participation in Dordt Athletics and is optional.

The Dordt Drug Testing Policy can be found here.

PDF

It appears your Web browser is not configured to display PDF files. Download adobe Acrobat or click here to download the PDF file.