Student Health History

Every student is required to complete health history and obtain a physical from a health practitioner. We do ask you to use our form, but you do not need a separate physical. You can take our form in when you get your physical for school, Scouts, sports, church, or other organizations and have your doctor fill it out at the same time as your other forms. The physical is required to be within one year prior from the first day of camp. This form is due to your Rotary Club RYLA Representative by June 1.

Should you have questions, contact your Great Plains Rotary Club RYLA Representative.

Please download the form below. You are encouraged to type directly into the form rather than hand writing. You also will have the ability to upload the front and back of your insurance card directly into the form. Please contact your RYLA Representative if you have questions.

RYLA Medical Record

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