New Athlete Registration
Please fill in this form to register as a new athlete for any Seattle Adaptive Sports Programs you participate in. If you have registered as an athlete with Seattle Adaptive Sports in the past, even if it's been a few seasons, please fill in the returning athlete registration.
Email
*
example@example.com
Athlete Information
Please complete all required questions
Person completing this form
*
Adult Athlete (Age 18+)
Minor Athlete (under age 18)
Parent/Guardian of Minor Athlete
Other
Name
*
First Name
Last Name
Nickname
Gender
*
Female
Male
Non Binary
Prefer Not to Answer
Other
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Date of Birth
*
Ethnicity
*
African American / Black
American Indian / Alaska Native
Asian
Hispanic / Latino
Middle Eastern
White
Prefer Not to Answer
Primary language spoken at home
Education and Employment
Your responses help us get to know our membership base. Please complete the fields that apply to you.
Are you/the athlete a student?
Yes
No
Name of School/Grade Level
Are you/the athlete employed?
Yes
No
Athlete's employer/occupation
Employer location
Example: Seattle, WA
Does your employer have charity matching?
Yes
No
I don't know/I'll find out
Does your employer have a volunteer program?
Yes
No
I don't know/I'll find out
Athlete Disability Information
All responses are confidential
Please submit a travel medical form at this link: https://hipaa.jotform.com/amorisondc/seattle-adaptive-sports-travel-med Please type your full name to acknowledge that you have turned this form in.
*
The form is only seen by your coach or the volunteer medical staff member for your team and will only be given to emergency medical personnel in the event of emergency care being needed. Parent/Guardian signatures and permissions will be given for minor athletes (under 18).
Disability Origin
*
Acquired
Birth
No Disability
If acquired, what is your date of disability?
Are your immunizations up to date?
*
Yes
No
Other
Date of last tetanus shot?
*
Have you ever broken any bones? (please list)
*
If none, please type N/A
Past surgeries with date(s)
*
If none, please type N/A
Have you ever had back fusion/ do you have rods in your back?
*
Yes
No
Other
Do you have a shunt?
*
Yes
No
If you've ever had a shunt malfunction, what were the symptoms?
Do you have any organs missing? (please specify)
*
If none, please type N/A
Have you ever experienced dizzy spells or have you passed out while exercising?
*
Yes
No
Do you have any history of pressure ulcers?
*
Yes
No
Has anyone in your family had a sudden death or heart attack before 50 years old?
*
Yes
No
Do you transfer?
*
I can transfer independently
I need some assistance
I need full assistance
Other
Do you have any problems with?
*
Overheating
Dysreflexia
Spasticity
Pain
None
Other
Are any of these problems made worse by exercise or activity?
Yes
No
What sports would you like to participate in?
*
Wheelchair Basketball
Sled Hockey
Power Soccer
Goalball
Your sports classification (if known)
Waivers and Forms
Please read the liability waiver here: http://nebula.wsimg.com/6a9d5e5b293a42d3f53c196e695eaf7e?AccessKeyId=FE260DB0078FD9887AF2&disposition=0&alloworigin=1 Please review the team policies here: http://nebula.wsimg.com/6728f5666b5014e42c6342db4f3dff0c?AccessKeyId=FE260DB0078FD9887AF2&disposition=0&alloworigin=1 Please review the athlete code of conduct here: http://nebula.wsimg.com/19864a83fcfaf769d7a104ad09aa867b?AccessKeyId=FE260DB0078FD9887AF2&disposition=0&alloworigin=1 Please review the concussion fact sheet here: http://nebula.wsimg.com/1fa17c0c2d1cf464460f01ec2069c54d?AccessKeyId=FE260DB0078FD9887AF2&disposition=0&alloworigin=1
My typed signature gives my acknowledgement of the liability waiver policies, team policies, code of conduct and concussion fact sheet. If you prefer to upload hand signed documents, you can do it on the next question.
*
Please type your full name below. If athlete is a minor (under 18) this will be the parent/guardian name.
Please upload your signed liability waiver, team policies document, and code of conduct document here.(Alternately, a link for an electronic signature can be sent via email).
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Permission is given to Seattle Adaptive Sports or competition organizing committee to seek medical care in case of emergency for the athlete named in this profile. The travel medical form lists types of care allowed. Please be sure to fill it in so we can respect your wishes regarding the care you wish to receive.
*
Yes
No
If you are borrowing equipment for the season, please sign and upload the equipment loan form and use the PayPal button on the membership page to pay your season equipment loan fee when you pay for your membership. http://nebula.wsimg.com/487dd72c2cc5cdf0a3e02ff80452ae41?AccessKeyId=FE260DB0078FD9887AF2&disposition=0&alloworigin=1
Browse Files
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Choose a file
Cancel
of
Athlete Volunteer Opportunities
Seattle Adaptive Sports exists because of the time and energy volunteers give to our programs and operations. Let us know where you can lend your talents to grow and strengthen our organization.
Are you interested in volunteering for SAS?
Yes
No
Optional Information
When contacted by the media, we would like to know more about your accomplishments:
Do you have any awards or recognition?
Yes
No
Tell us about any awards or recognition you have received.
Do you belong to any other groups or clubs?
Yes
No
What groups or clubs to you belong to? (List any other groups or clubs you are a member of)
Any other information you would like us to know?
Submit
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