Athlete Waiver – Coach O

01

Personal Information

First Name (Required)

Last Name (Required)

Email (Required)

Address: (Required)

Street Address

City

State / Province / Region

Postal / Zip Code

Phone

Type :

HomeWorkCell

02

Emergency Contact

First Name

Last Name

Phone

03

Meet Availability

Please select all the days you will be available:

Saturday, 6th March 2027Sunday, 7th March 2027

04

Medical

List any allergies, medications, or medications we should be aware of:

05

Certification

Certification Number

Is this certification current?

YesNo

Certification Details

06

Work Preferences

Please select four (4) areas you would like to work in order of preference
DO NOT select same area for all 4 choices

Preference 1:

Preference 2:

Preference 3:

Preference 4:

07

Travel & Lodging

How will you be traveling?:

AirCarOther (Explain below)

Other travel arrangements

If arriving by car, please note your mileage

Roommate Preference:

I will not need housing accommodationsPlease assign me a roommateI would like to room with the individual(s) listed below

Lodging will be by request only and it must be communicated in advance.

Roommate(s) Requested:

Dietary Request:

Dietary Request (Please Specify)

Physical Limitations:

08

Upload USATF Certification Badge

Upload USATF Certification BadgeMax. file size: 64 MB.Please upload a headshot and picture of your officials certification card. File formats accepted: jpg, jpeg, png, gif, pdf, doc, docx, xls, xlsx.

James Folston Sr. Youth Opner: Presented By E.O.T.O. Elite

Personal Information

Emergency Contact

Meet Availability

Medical

Certification

Work Preferences

Travel & Lodging

Upload USATF Certification Badge

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