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USD Afterschool Strength Training Registration
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Student's Full Name
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Your answer
Student's Address
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Your answer
Student's Age
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Your answer
Student's Gender
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Your answer
Which USD school does the student attend?
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Eagle View Elementary
Uintah Middle School
Uintah Online
Vernal Middle School
Please list the sport or sports the student plays or plans to play.
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Your answer
Parent/Guardian's Name
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Your answer
Parent/Guardian's Phone Number
Your answer
Emergency Contact
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Your answer
Emergency Contact's Relationship to Student
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Your answer
Emergency Contact's Phone Number
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Your answer
Insurance Information (Please enter NONE if the student is uninsured.)
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Your answer
List any health concerns or prescribed medications for the student. (Please enter N/A is this is not applicable.)
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