ReDefine Athlete Application
Thank you for your interest in the Adaptive Training Foundation ReDefine program!

Between March 26th and June 18th we will be accepting applications for our ReDefine Class 13!

This class is scheduled to begin on July 30th. If you think you have what it takes to become a part of the tribe please take the time to fill out the following questions to the best of your ability.

Don't forget... Impossible is just an opinion.

Name *
First and Last
Name of person filling out application (if different from above)
Email *
Date of Birth *
MM
/
DD
/
YYYY
Address Line 1 *
Address Line 2
City *
State *
Zip Code *
Phone Number *
Please enter number as: ###-###-####
Sex *
Injury *
Date of Injury *
MM
/
DD
/
YYYY
Marital Status *
Household Size *
Highest Level of Education *
What is your Disability Rating?
(%)
Employment Status *
Describe your home life... *
Hobbies, skills, interests, etc... *
Upload a picture of yourself
Please note, you application will not be complete without a Picture! Please ensure you have come back and uploaded it in a timely manner!
Emergency Contact *
First and Last name
Relationship *
Phone Number (ICE) *
Please use ###-###-####
Alternate Phone
Disclaimer
If your records have been expunged pursuant to applicable law, you are not required to answer yes to the following questions. If you are unsure whether to answer yes, we strongly suggest that you answer yes and fully disclose all incidents.
Have you ever been charged with a violation of the law which resulted in, or if still pending could result in, probation, community service, a jail sentence, or the revocation or suspension of your driver’s license (including traffic violations which resulted in a fine of $200 or more?) *
If yes, please explain
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