2018 ATLANTA RAINBOW TROUT AQUATICS MEMBERSHIP FORM
IMPORTANT: You must provide your Full Name as it appears on your driver's license! You will have to show your driver's license when you have your picture taken. If the names do not match, Georgia Tech will refuse to issue your CRC Access Card.
Email address *
Last Name *
Your answer
Legal First Name *
List your first name as it appears on your driver's license.
Your answer
Preferred First Name
Please indicate the name you go by
Your answer
Middle Name *
Your answer
Date of Birth *
mm/dd/yyyy
Your answer
Gender *
Email Address *
Enter the email address where you wish to receive team related announcements
Your answer
Buzzcard Number OR Georgia Tech Campus Recreation Center (CRC) Access Card
If you have a Buzzcard (9 digits 90#######) or CRC Access Card (6 Digits 64####), enter the number here
Your answer
Phone Number *
List your preferred phone number. XXX-XXX-XXXX
Your answer
Emergency Contact Name *
Who should we call in case of emergency?
Your answer
Emergency Contact Phone Number *
XXX-XXX-XXXX
Your answer
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