SNAP SPORTS ATHLETE REGISTRATION DETAIL

New or Returning
New

— ATHLETE —

Last
First
Middle
Preferred
Warloe
Beckie

Gender
DOB
Race
Specific Origin Group
Female
July 11, 1995
[35]
[36]

Language(s) spoken
Other
English

Address
22835 Banyan Pl
City
State
Zip
Santa Clarita
CA
91390-4259
Phone
Email
6614332174
bwarloe31@gmail.com

Sports activities

Athlete Employer

Does the athlete have the capacity to consent to medical treatment on his or her own behalf?
Yes

— PARENT / GUARDIAN / CONSERVATOR INFORMATION—

Name
Relationship
Blah
Sister
Street Address
22835 Banyan Pl
City
State
Zip
Santa Clarita
CA
91390-4259
Email
Phone
bwarloe31@gmail.com
6614332174

— EMERGENCY CONTACT INFORMATION —

Name
Relationship
Batman
Husband
Phone
Alternate Phone
Email
6122533695
bwarloe31@gmail.com

— PHYSICIAN & INSURANCE INFORMATION —

Physician Name
Physician Phone
Who knows
661999999
Insurance Company
Policy Number
Group Number
The worst
0987654321
113

— ATHLETE RELEASE FORM —
Athlete Name
Athlete Signature
Beckie Warloe
Parent/Guardian/Conservator Name
Parent/Guardian/Conservator Signature
Date
Blah
March 18, 2020

— ATHLETE LIKENESS RELEASE FORM —
Athlete Name
Athlete Signature
Beckie Warloe
Parent/Guardian/Conservator Name
Parent/Guardian/Conservator Signature
Date
Blah
March 18, 2020

— ATHLETIC WAIVER, RELEASE OF LIABILITY AND SNAP SPORTS – CORONAVIRUS/COVID-19 LIABILITY WAIVER —
Athlete Name
Athlete Signature
Beckie Warloe
Parent/Guardian/Conservator Name
Parent/Guardian/Conservator Signature
Date
Blah
March 18, 2020

— CORONAVIRUS/COVID-19 FIELD RESERVATION LIABILITY WAIVER —
Athlete Name
Athlete Signature
Parent/Guardian/Conservator Name
Parent/Guardian/Conservator Signature
Date
Blah

I AGREE TO THE SNAP SPORTS TEAM TRAVEL POLICY

I AGREE TO THE SNAP SPORTS MEMBERSHIP POLICY

I AGREE WITH THE SNAP SPORTS SEXUAL ABUSE AWARENESS POLICY

I AGREE TO THE SNAP SPORTS DISCIPLINARY POLICY & PROCEDURES

I AGREE TO THE SNAP SPORTS CONCUSSION AWARENESS AND SAFETY RECOGNITION POLICY & PROCEDURES