NEED 4 SPEED COMBINE

Athlete Registration

Before You Begin: All programs are structured for measurable performance results. Sessions are limited to maintain elite coaching quality. For purposes of the combine athlete profile and consent waiver, parents will have to register each athlete separately.
Event Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Athlete Information
Athlete's Name

First NameLast Name
Birth Date

MonthDayYear
Gender

Other
Grade
*IF APPLICABLE*
Height
Weight

Clothes Sizes

Rows	Y Small	Y M	Y Large	Small	Medium	Large	XL	XXL
Shirt

What school do you attend?
*IF APPLICABLE*
What Sports do you play?

Other
How many years have you played organized sports?
What NFL Leagues United Region and Division do/would you play for?
*IF APPLICABLE*
Phone Number

Area CodePhone Number
Email
example@example.com
Social Media Handles
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Who referred you to GAINZ?
Athlete's Name
Who is your preferred coach?
Who is your 2nd choice?
Parent/Guardian Information

*IF UNDER AGE 18*
Name

First NameLast Name
Home Number

Area CodePhone Number
Cell Number

Area CodePhone Number
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number

Area CodePhone Number
Alt. Phone Number

Area CodePhone Number
Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.
Is the athlete prescribed an inhaler or other medications? If yes, please explain any instructions.
Has the athlete had any sports related injuries in the past 12 months?
Informed Consent and Acknowledgement

Attached is the GAINZ Sports Performance Athletic Waiver. Please read carefully before signing.
Confirmation

BY ACKNOWLEDGING AND SUBMITTING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature
Should be Empty:

Athlete Registration