Avatar Upload Remove ATHLETE INFORMATION * Date of Birth ( mm/dd/yyyy ) HOME ADDRESS * Address 1 * State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Language(s) Spoken in Athlete’s Home (Optional): Check all that apply EnglishUkrainian PARENT / GUARDIAN INFORMATION, IF ATHLETE IS UNDER 18 YEARS OLD Parent / Guardian Address Address the same as Athlete, if Different: EMERGENCY CONTACT MEDICAL INFORMATION Any allergies foodmedication By selecting the box below, you confirm that all information provided is true and accurate. I acknowledge that the information provided is true and accurate *If the applicant is under 18 years old, a parent or guardian must provide consent. Parent Confirmation I am the applicant's parent/guardian and consent to this application. Download and Print the Physical Form Here ANNUAL ATHLETE PHYSICAL FORM Enter the Date Of Physical Exam ( mm/dd/yyyy ) * Expiration Date ( Auto-Calculated ) Upload the Completed Physical Form Here Upload Athlete Waiver Form The form must be signed by a doctor Accept our Terms&Conditions Share this: Share on Facebook (Opens in new window) Facebook More Share on X (Opens in new window) X
