Lake Shore Region Emergency Contact Form for participants18 years and up
For USPC Members 18 and up

The age of majority is the threshold of adulthood in law. As USPC members above the age of majority are adults in the eyes of the law and therefore responsible for themselves, USPC does not require a “chaperone” for these members at competitions. USPC does require that members above the age of majority submit emergency contact information for each competition. Age of majority vary per state.
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Club/Center *
Participant First & Last Name *
Participant Phone Number *
Participant Email Address *
State of Residence *
Regional Activity Name *
Regional Activity Date *
Emergency Contact First & Last Name *
Emergency Contact Relationship to Participant *
Emergency Contact Cell Phone # *
Emergency Contact Home Phone #
Seondary Emergency Contact Name - optional
Seondary Emergency Contact Relationship to Participant
Seondary Emergency Contact Cell Phone #
Secondary Emergency Contact Home Phone #
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