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Annual Athlete Information Form

For new participants, please complete the entire form and submit your $50 annual Seattle Adaptive Sports (SAS) membership fee, or apply for Scholarship. You will be asked to review and confirm understanding of several agreements, including release of liability, before final submission. For existing SAS athletes with current memberships, this form must be updated annually, either when membership fees are due, or when personal or medical information changes. Information entered in this form is used by coaches or medical professionals in the event of an emergency, and is kept confidential. 

Participant Information
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First Name
Last Name
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(mm/dd/yyyy)
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First Name
Last Name
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country




Please identify both medicine-related and environmental/food allergies and describe severity and reaction if exposed. e.g. "Moderate allergy to latex, reaction of hives." Enter NONE if no allergies.
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Include dose and frequency, and any emergency/rescue medications. Enter NONE if no medications are taken.
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Emergency Contact
Please be sure to alert your contacts and update information as frequently as necessary.
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First Name
Last Name
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Membership Purchase or Renewal
Scholarship Application

Seattle Adaptive Sports does not want cost to be a barrier to participation. If you would like to request financial assistace, please leave the membership purchase unselected and upload your most recent 1040 Tax Return or Social Security Income for Disability Form (SSI). Other acceptaple proof of income/eligibility is listed below. Upon receipt, you will be contacted by the Program Director within 10 business days regarding the status of your application. 


Acceptable documents include most recent 1040 Federal Income Tax Return, Social Security benefits documentation: SSI or SSA-1099, Full-time student verification, TANF, or proof of City of Seattle Utility Discount program qualification
Waiver and Release of Liability
Participants must read and agree to the information below, and confirm understanding of the Athlete Code of Conduct, Team Policies, and Concussion Fact Sheet, available on the Seattle Adaptive Sports website.
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The Seattle Adaptive Sports is committed to conducting its recreation programs and transportation service in a safe manner and holds the safety of participants in high regard. The Seattle Adaptive Sports continually strives to reduce such risks and insists that all participants follow safety rules and instructions that are designed to protect the participant’s safety. However, participants and parents/guardians of minor children/wards registering for programs/activities must recognize that there is an inherent risk of injury when choosing to participate in recreational and athletic activities/programs/transportation. You are solely responsible for determining if you or your minor child/ward is physically fit and/or skilled for the activities contemplated by this agreement. It is always advisable, especially if the participant is disabled in any way, recently suffered an illness, injury or impairment, or is pregnant, to consult a physician before undertaking any physical activity. WARNING OF RISK. Recreational and athletic activities/programs are intended to challenge and engage the physical, mental, and emotional resources of each participant. When Seattle Adaptive Sports provides transportation, it is for the convenience of the participant and enhancement of the program. Despite careful and proper preparation, instruction, medical advice, conditioning, and equipment, there is still a risk of injury when participating in any recreational and athletic activity/program. Understandably, not all hazards and dangers can be foreseen. Depending on the particular activity, participants and parents/guardians of minor children/wards must understand that certain risks, dangers, and injuries due to inclement weather, slipping, falling, poor skill level or conditioning, carelessness, horseplay, unsportsmanlike conduct, premises defects, inadequate or defective equipment, inadequate supervision, instruction or officiating, and all other circumstances inherent to indoor and outdoor recreational and athletic activities/programs exist. In this regard, it must be recognized that it is impossible for the Seattle Adaptive Sports to guarantee absolute safety. WAIVER AND RELEASE OF ALL CLAIMS AND ASSUMPTIONS OF RISK. Please read this form carefully and be aware that in signing up and participating in programs/activities/transportation, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your minor child/ward might sustain as a result of participating in any and all activities connected with and associated with said programs/activities (including transportation services/vehicle operation when provided). I recognize and acknowledge that there are certain risks of physical injury to participants in these programs/activities/transportation, and I voluntarily agree to assume the full risk of any and all injuries, damages or loss, regardless of severity, and that my minor child/ward may have (or accrue to me or my child/ward) as a result of participating in any and all activities connected with and associated with these programs/activities (including transportation services/vehicle operation, when provided). I do hereby agree to fully waive, relinquish, release, and forever discharge the Seattle Adaptive Sports, including its officials, agents, volunteers, and employees (hereinafter collectively referred as Seattle Adaptive Sports) from any and all claims for injuries, damages, or loss that my minor child/ward or I may have or which may accrue to me or my minor child/ward and arising out of, connected with, or in any way associated with these programs/activities. I further agree to indemnify and hold harmless and defend Seattle Adaptive Sports from and against any losses, claims, damages to property occurring, growing out of, incident to, or resulting directly or indirectly from my minor child/ward or my participation in any and all activities connected with and associated with these programs/activities. COVID-19 RISKS OF PARTICIPATION. The Participant and/or guardian recognizes and understands that while Released Parties have undertaken reasonable steps to lessen the risk of transmission of communicable diseases, including but not limited to, COVID-19, in connection with participation in the activities, the Released Parties are not responsible in any manner for any risks related to communicable diseases in connection with Participant’s participation in the activities. Specifically, the participant and/or guardian understands that COVID-19 is a highly contagious and dangerous disease, and that contact with the virus that causes COVID-19 may result in significant personal injury or death. The participant and/or guardian is fully aware that participation in the activities carries with it certain inherent risks related to transmission of communicable diseases (“Inherent Risks”) that cannot be eliminated regardless of the care taken to avoid such risks. The participant and/or guardian hereby voluntarily accepts and assumes all risk of loss, personal injury, sickness, death, damage, and expense for the Participant arising from such Inherent Risks. Furthermore, the participant and/or guardian represents and warrants that Participant does not knowingly carry any communicable diseases that may be transmitted during participation in the activities.