Athlete National Team Intake Form

Welcome to the GymCan National Team!
Please complete this form to provide the information GymCan needs to establish and maintain your National Team records. Please ensure all information is accurate and current.

Athlete Information

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First name *

Last name *

Email *

Mobile *

Date of birth *

Address *

City *

Country *

State/Province *

Zip/Postal code *

Preferred Home Airport *

Preferred Seat on Flights *

Airline Loyalty Program & Membership Number

Dietary Restrictions and / or allergies Please identify any dietary restrictions or allergies GymCan should be aware of. Leave black if not applicable.

City of birth *

Discipline *

ACRO DMT MAG RG TRA TUM WAG

Preferred language of communication:

Emergency Contact Person

Relationship

First name *

Last name *

Email *

Mobile *

Parent/Guardian Information *

Parent/Guardian information is MANDATORY if the athlete is under 18

The Parent/Guardian information is the same as noted above

Yes No

I would like to have my Parent / Guardian copied on all communication *

For athletes over 18.

Yes No

If Parent/ Guardian information is different, please complete the information below

Relationship

First name

Last name

Email

Mobile

Personal Headshot *

Please upload a passport-like portrait photo.

Photo must meet the following criteria:

No larger than 1MB
Plain neutral colour background - no patterns, objects, other people
Must see full face - no hats, sunglasses
Image quality - no heavy shadows or low lighting

This photo will be used for National Team administrative purposes, including applicable accreditation.

Athlete National Team Intake Form

Athlete Information

Discipline *

Preferred language of communication:

Emergency Contact Person

Parent/Guardian Information *

I would like to have my Parent / Guardian copied on all communication *

If Parent/ Guardian information is different, please complete the information below

Personal Headshot *

Primary Coach *

Primary Coach email *

Additional Coach(es)

Additional Coach(es) email(s)

Club *

Club contact (name and job title)

Club Contact email

Would you like this Club Contact copied on National Team communications? *