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SRHS Mountain Bike Team Registration Form
SRHS Mountain Bike Team (MBT) registration form, required annually before participation in any SRHS MTB ride.
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* Indicates required question
Athlete's First Name
*
Your answer
Athlete's Last Name
*
Your answer
Athlete's Email
*
Your answer
Athlete's Cell Phone
*
Your answer
Athlete's Home Phone
Your answer
Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Last Semester GPA (for eligibility)
*
Your answer
Current GPA
*
Your answer
Grade
*
Choose
Freshman
Sophomore
Junior
Senior
Athlete's Birthdate
*
Your answer
Parent/Guardian 1 (First Name)
*
Your answer
Parent/Guardian
1 (Last Name)
*
Your answer
Parent/Guardian
1 (Cell Phone)
*
Your answer
Parent/Guardian
1 (Email)
*
Your answer
Parent/Guardian
2 (First Name)
Your answer
Parent/Guardian
2 (Last Name)
Your answer
Parent/Guardian
2 (Cell Phone)
Your answer
Parent/Guardian
2 (Email)
Your answer
Emergency Contact (First Name)
*
Your answer
Emergency Contact (Last Name)
*
Your answer
Emergency Contact's Phone
*
Your answer
Has Athlete had a physical in the past year?
*
Choose
Yes
No
Does Athlete have Asthma?
*
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Yes
No
Does Athlete carry rescue inhaler?
*
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Yes
No
Does Athlete have Allergies?
*
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Yes
No
Does Athlete carry an EpiPen?
*
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Yes
No
Allergies
Your answer
Medical Conditions (Confidential)
Your answer
Athlete's Health Insurance Provider AND Policy or Group Number
*
Your answer
Any special notes or questions for the coaches? Include them here.
Your answer
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