Team USA Registration Form
Lake Placid 2023 FISU World University Games
Country/Region
*
Please Select
USA
Family Name (Last Name)
*
Given Name (First Name)
*
Individual's Preferred Family Name
Individual's Preferred Given Name
Nationality
*
Please Select
USA
Gender
*
Please Select
M
F
Date of birth (date format dd-mm-yyyy)
*
/
Day
/
Month
Year
Date
Place of birth
*
Please Select
USA
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Passport Information
Note: passport should be valid at least 6 months after the end of the FISU World University Games, ie.07/22/2023. The maximum size for a file is 200MB.
ID Document Number
*
Passport Expiration Date
*
-
Day
-
Month
Year
Date
Passport Data Page [ Save as: FirstnameLastname_USA_Passport.jpg]
*
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Address and Email
Address
Street Address
Street Address Line 2
City
State
Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Email
*
example@example.com
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VISA Information
Is a Visa Invitation Letter needed?
No
Yes
City Of Visa Issuing (Mandatory if "VISA Support"=TRUE)
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Photograph and FISU Certificate of Academic Eligibility
The maximum size for a file is 200MB .
Upload Head Shot Photograph: Please note the following instructions: The digital photo must: contain no other object or people -- must be taken against a plain, light-colored background -- must be in clear contrast to the background -- You must be facing forward and looking at the camera, eyes open and visible -- You must not have hair in front of your eyes -- You must not have a head covering unless for religious or medical reasons -- nothing covering your face -- no shadows on your face or behind you -- no headphones or any other device. [Please save your file as: FirstnameLastname_USA_Picture.jpg]
*
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FISU Certificate of Academic Eligibility [Save as: FirstnameLastname_USA_EF.pdf]
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Proof of Vaccination
Vaccination Brand
*
Please Select
Janssen/J&J
Convidecia (CanSinoBIO)
Comimaty (Pfizer-BioNTech)
Spikevax (Moderna0
Vaxzevria (Astraeneca)
Covaxin
Covishield
BIBP/Sinopharm
CoronaVAC (Sinovac)
Nuvaxovid (Novavax)
Covovax
Number of Doses
*
Please Select
1 dose
2 doses
3 doses
4 doses
Date of Dose 1
*
-
Day
-
Month
Year
Date
Date of Dose 2 (if applicable)
-
Day
-
Month
Year
Date
Date of Dose 3 (if applicable
-
Day
-
Month
Year
Date
Date of Dose 4 (if applicable)
-
Day
-
Month
Year
Date
Please upload copy of your COVID-19 vaccination card. Save as: [FirstnameLastname_USA_Covid.jpg]
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I confirm that I am fully vaccinated according to US Covid-19 requirements
*
Yes
No
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Sport Information
Sport
*
Please Select
ALP - Alpine Skiing
BTH - Biathlon
CCS - Cross-Country Skiing
CUR - Curling
FRS - Freestyle & Freeski
FSK - Figure Skating
IHO - Ice Hockey
NCB - Nordic Combined
SBD - Snowboard
SJP - Ski Jumping
SSK - Speed Skating
STK - Short Track Speed Skating
Height in centimeters (cm)
*
Weight in kilograms (kg)
*
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Emergency Contact Information
Contact Family Name
*
Contact Given Name
*
Phone Number
*
Please enter a valid phone number.
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Insurance Information
Has insurance?
*
No
Yes
Health Insurance Company
Health Insurance Policy Number
Accident Insurance Company
Accident Insurance Policy Number
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University or College Enrollment Information
Country of University
*
City of University
*
University
*
Faculty
Field of Study
*
Please Select
Humanities
Social Sciences
Natural Sciences
Formal Sciences
Applied Sciences
Medicine and Health
Physical Education and Sport
Year of Study
*
Please Select
1st year
2nd year
3rd year
4th year
5th year
6th year
7th year
8th year
9th year
10th year
Graduated
Graduation Date (date format dd-mm-yyyy)
/
Day
/
Month
Year
Date
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Travel Information
Arrival Date and Time (24 Hours)
/
Day
/
Month
Year
Date
Hour Minutes
Departure Date and Time (24 Hours)
/
Day
/
Month
Year
Date
Hour Minutes
Number (e.g., flight, train, etc.)
Airport/Train Station (name only)
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Do you accept that some of your personal data may be transmitted to FISU partners?
*
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No
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