Returning Participant Registration

Returning Participant Registration

If you have previously registered for any Seattle Adaptive Sports programs, please fill this form in. If you have never registered for a program at Seattle Adaptive Sports, please go back to the Membership page and fill in the New Participant Registration.
Name*

First NameLast Name
Email*
example@example.com
Nickname
Gender Identity*

FemaleMaleNon BinaryPrefer Not to AnswerOther
Person completing this form*

Adult Athlete (Age 18+)Minor Athlete (Under age 18)Parent/Guardian of Minor AthleteOther
Participant Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Date of Birth*
Primary Disability*
If you are an athlete and have not previously submitted a Travel Medical Information Form, please do so at this time.
What is your total annual income?

$0-$30,000$31,000-$60,000$61,000-$90,000$91,000-$120,000$120,000+Prefer not to share
Are you a Veteran?*

YesNoPrefer not to share
If yes, what branch of service?
Information Updates

Below you will find questions about your previously entered information. If you have any changes to add, please enter them in the appropriate field.
Enter updated emergency contact information or indicate N/A.*
Enter updated school or employment information or indicate N/A.*
Please list any changes to medications, allergies, or any new medical changes relevant to participation in SAS programs (such as changes to assistive devices, assistance needs, new implanted devices, etc). If no changes, type N/A.*
Select item(s) that have any changes

MedicationsAllergiesInsuranceDisabilityAssistive DevicesImplanted DevicesSurgeriesNone of the Above
If your medical information has changed, please submit a new Travel Medical Information Form.
Consent to Treat
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*

YesNo
Please list any changes to your disability information. If no changes, type N/A.*
Sports Information
What sports will you participate in this season?*

Wheelchair Basketball - PrepWheelchair Basketball - VarsityWheelchair Basketball - AdultWheelchair Basketball - Women'sSled HockeyPower SoccerGoalball
Your sports classification (if known)
Waivers

Please review and sign the following waivers:
Move United (ALL PARTICIPANTS)

Seattle Adaptive Sports Participant
Policy Forms

Please review the following SAS Policies:
Team Policies

Participant Code of Conduct

Concussion Fact Sheet

Parental Code of Conduct

Equipment Loan Policy
My typed signature gives my acknowledgement of the Team Policies, Codes of Conduct, and Concussion Fact Sheet. *
Please type your full name. If you prefer to upload signed documents, you can include it with the question below.
If you have not already submitted a travel medical form, please do so at this link: hipaa.jotform.com/220314796746058 Parent/Guardian signatures and permissions will be given for minor athletes (under 18). Please type your name to acknowledge that you have turned this form in.*
The form is only seen by your coach or the volunteer medical staff and will only be given to emergency medical personnel in the event of emergency care being needed.
If you are borrowing equipment for the season, please complete and upload a completed Equipment Loan Policy form and use the checkbox below to pay your season equipment loan fee.

Cancelof
My Products
prevnext( X )
Membership Fee
$75.00 Quantity

Equipment Loan Fee
$100.00 Quantity

Total

$0.00

Payment Methods

Debit or Credit Card

Please click one of the PayPal options to complete payment and submit the form.

Should be Empty:

Returning Participant Registration

Information Updates

Consent to Treat

Sports Information

Waivers

Policy Forms