Rio Salado Target Terminators Information Sheet 2017 - 20178
Athlete Name *
Please type First and Last name of the Athlete
Your answer
Male or Female *
DOB of the Athlete *
Please enter the Date of Birth of the Athlete
MM
/
DD
/
YYYY
Address *
Please enter the Athlete's address
Your answer
Current Grade Level *
Please enter the current grade level of the althete (i.e. 6th, 7th)
Your answer
School Name *
Please enter the name of the school the athlete is attending
Your answer
Has the Athlete previously participated in an SCTP program? *
Please list the Club if different than Rio Salado
Your answer
Is the Athlete or imediate family a member of Rio Salado Sportsman Club? *
Adult T-Shirt Size *
Athlete's Father's Name *
Your answer
Athlete's Father's Email Address *
Your answer
Athlete's Father's Phone Number *
Your answer
Athlete's Mother's Name *
Your answer
Athlete's Mother's Email Address *
Your answer
Athlete's Mother's Phone Number
Your answer
Other Guardians
Please list below
Your answer
Emergency Contact Name (Other than the Partents) *
Your answer
Emergency Contact Relationship to the Athlete *
Your answer
Emergency Contact Phone *
Your answer
Medical Conditions *
Please list any medical conditions we should be aware of taking into account the nature of the activity.
Your answer
Additional Emails #1 - Enter Name
Your answer
Additional Emails #1 - Enter Email
Your answer
Additional Emails #2 - Enter Name
Your answer
Additional Emails #2 - Enter Email
Your answer
Additional Emails #3 - Enter Name
Your answer
Additional Emails #3 - Enter Email
Your answer
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