Sport Science Athlete Intake Form

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Please complete and Submit the following prior to your first session at Sport Science Rehab and Performance. This athlete intake information is vital as its required to create athlete profiles and to streamline communication systems to best support athletes and families.

Which program are you registering for? *

Brent's Running Group Strength Training (Wednesdays @ 6:30pm)

Mission Volleyball 16UG (Mondays @ 6:30pm)

U13 Spring Hockey

Please read the Sport Science Liability Waiver document linked here and agree to its terms and conditions below. Sport Science Liability Waiver *

I am 18 years old / I am the legal guardian of the athlete registering below

I fully understand and agree to the terms listed on liability waiver

Required

Please read the Professional Medical Environment Policy document linked here and agree to its terms and conditions below. Professional Training Environment Policy *

I have read the patient behavior expectations and commit to upholding them to the best of my ability.

Required

Athlete's full name (first and last) *

Date of Birth *

YYYY

Email Address *

Phone Number *

Coach Name

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