Athlete Information
What is your legal last name?
Your answer
What is your legal first name?
Your answer
What is your student identification number?
Your answer
What is your email address?
Your answer
What is your date of birth?
MM
/
DD
/
YYYY
How old are you?
Your answer
What is your athletic level?
What sport will you play?
Do you have health insurance?
Do you have dental insurance?
Do you have Medi-Cal?
What is your gender?
What is your contact phone?
Your answer
What is your address?
Your answer
What city do you live in?
Your answer
What state do you live in?
Your answer
What is your zip code?
Your answer
What is the first and last name of a person we can contact in case of an emergency?
Your answer
What is your emergency contact's phone?
Your answer
What is your emergency contact's relationship to you?
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms