AWL Staff, Coaches & Carers Registration (for Team Trips)

Staff, Coaches & Carers Registration Form

FOR ATHLETES WITHOUT LIMITS TEAM TRIPS & EVENTS
Today's Date

MonthDayYear
Which important role do you have?*
What is your Sport?*
Contact Information
Name:*

First NameLast Name
Date of Birth:*

MonthDayYear
Age
Email (for form confirmation):*
Please double check this is important!
Cell Phone for WhatsApp Groups
Please enter a valid phone number.
Mailing Address (where you can accept a package with team gear):*

Street Address

Street Address Line 2

CityState

Zip Code
Sizes for Gear
Warmup Jacket Size:*
Track Pants/Shorts Size:*
Tshirt/Polo Size:*
Size Notes (optional)
Credentials
Passport Number*
Passport Expiration Date*

MonthDayYear
Does we have a copy of your current Passport from a previous trip?*

Yes, AWL has my Passport alreadyNo, I need to upload my current Passport
Upload Passport Image (for new staff):

If we don't already have your Passport from a previous trip please upload it here.
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Upload Preferred Headshot (new staff or new preferred pic)

If we don't already have your headshot from a previous event please upload it here.
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Emergency Medical
Dietary Preferences*

No PreferenceVeganVegetarianOther
Food Allergies*

No Food AllergiesMilkEggsFish (e.g., bass, flounder, cod)Crustacean shellfish (e.g., crab, lobster, shrimp)Tree nuts (e.g., almonds, walnuts, pecans)PeanutsWheatSoybeansSesameOther
Do you have any medical conditions, medications, or other important medical notes that our staff should know about in an emergency?

No important medical notes.Yes see medical notes below.
Emergency Medical Notes:
Do you have any medical conditions, medications, or medication allergies or other information our team leaders and medical support team should know about in an emergency.
Emergency Contact
Emergency Medical Contact Name:*
Emergency Medical Contact Relationship:*
Emergency Medical Contact Phone:*
Please enter a valid phone number.
Emergency Medical Contact Email:*
example@example.com
Certifications & Athlete Safety
Please check all that apply - upload boxes will appear below so you can provide any related certificates:

I have Coaching Certifications from my SportI have Medical Staff CV/License/Malpractice Insurance to uploadI have completed Safesport TrainingI have completed CDC Concussion Awareness TrainingI will complete Safesport Training (link will be in confirmation email)I will complete CDC Concussion Awareness Training (link will be in confirmation email )Other
Upload Coaching Certifications

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Upload Medical CV/Certifications/Licenses/Malpractice Insurance, etc.

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Upload Safesport Certificate

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Upload CDC Concussion Training Certificate

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Upload Other Certifications

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Release Form & Signature
1. Medical/Trip Insurance: I/we understand that Athletes/coaches/staff must have medical insurance and/or travel insurance which covers any medical costs while traveling on Athletes Without Limits Team Trips and will confirm international coverage with our medical insurance plan and/or research additional travel/trip insurance options through our airline or other Travel Insurance plan. I/we acknowlege that Athletes Without Limits assumes no financial responsibility for air travel or medical expenses. By participating in competition you voluntarily assume all risks associated with exposure to Covid-19 and cannot hold Athletes Without Limits liable.
2. Liability Waiver: I/we would like to travel with and/or participate in group trips or events with Athletes Without Limits and acknowledge the risks and potential for risks of travel and participating in various sports. However feel that the possible benefits to myself/my son/my daughter/my ward are greater than the risk assumed. I/we hereby intend to be legally bound, for myself, my heirs and assigns, executors or administrators, waive and release forever all claims for damages against Athletes Without Limits, its Board of Directors, Coaches, Aids, Volunteers and/or Employees for any and all injuries and/or losses I/my son/my daughter/ my ward may sustain while traveling with Athletes Without Limits or while participating in, planning, or attending sporting, training and other events as part of Athletes Without Limits programming.
3. Payment Policies: In some cases carers or staff may be making payments for room and board, extra nights, extra guests, etc. We will email you a link to make this payment by bank transfer or card. Athletes Without Limits trip payment policies are below:
  
  Outstanding Invoices: All invoices must be paid by the due date in order to participate in the event unless special arrangements have been made.
  
  Refunds & Cancellations: Event fees are nonrefundable. Partial refunds due to illness/injuries may be considered on a case-by-case basis and depend upon how far along the team is on the payment timeline (and whether or not refunds from the Event organizers are possible).
  
  Event Cancellation: Should the event organizers or Athletes Without Limits have to cancel the trip for athlete or staff health and safety, or Force Majeure (reasons beyond our control like acts of nature, war, etc) Athletes Without Limits will try to obtain a refund for team payments made to the organizers in an effort to reimburse athletes/parents/coaches less any bank or credit card processing fees already charged for payments made — this will depend on the Virtus event organizers granting a refund if our US Team payment has already been sent.
Agreement*

By checking this box and signing my name electronically below I agree to medical/trip insurance policies, liability waiver and payment policieslisted above.
Signature

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Staff, Coaches & Carers Registration Form

Contact Information

Sizes for Gear

Credentials

Emergency Medical

Emergency Contact

Certifications & Athlete Safety

Release Form & Signature