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EMCA Athlete Registration Form
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* Indicates required question
Email
*
Your email
Athlete's First Name
*
Your answer
Athlete's Surname
*
Your answer
Athlete's Date of Birth
*
MM
/
DD
/
YYYY
Current School Year (if in education)
Your answer
Mobile Contact Number
*
Your answer
Emergency Contact Information
Contact 1 - Full Name
*
Your answer
Contact 1 - Relationship to Athlete
*
Your answer
Contact 1 - Mobile Number
*
Your answer
Contact 2 - Full Name
*
Your answer
Contact 2 - Relationship to Athlete
*
Your answer
Contact 2 - Mobile Number
*
Your answer
Medical Information
Any Known Allergies / Medical Conditions
*
Your answer
Any Medications Required
*
Your answer
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