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Athlete Waiver & Release for Sand Storm 2022 BOYS & GIRLS Events
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Club Information
Team
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Choose
Boys Team
Girls Team
Sand Storm 2022 CLUB Name
*
Your answer
Sand Storm 2022 TEAM Name
*
Your answer
Athlete Details
Athlete First Name
*
Your answer
Athlete Last Name
*
Your answer
Athlete Grad Year
*
Your answer
Athlete DOB
*
MM
/
DD
/
YYYY
Athlete State
*
Your answer
Athlete Email
*
Your answer
Athlete Phone
*
Your answer
Athlete Allergies / Medical Conditions
Your answer
Parent / Emergency Contact Information
Parent / Emergency Contact First Name 1
*
Your answer
Parent / Emergency Contact Last Name 1
*
Your answer
Parent / Emergency Contact Phone 1
*
Your answer
Parent / Emergency Contact Email 1
*
Your answer
Parent / Emergency Contact First Name 2
Your answer
Parent / Emergency Contact Last Name 2
Your answer
Parent / Emergency Contact Phone 2
Your answer
Parent / Emergency Contact Email 2
Your answer
Insurance
Insurance Provider
*
Your answer
Full Name of Policy Holder
*
Your answer
Policy #
*
Your answer
Group #
*
Your answer
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