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Please fill out the below form to provide us with all of the necessary information on your daughter attending the ATC Academy December 2024 USA Tour.

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Athlete Information

Athlete First Name

Athlete Last Name

Parent Email

Code

Parent Phone

Athlete Year in High School

Mother Name

Father Name

Emergency Contact Name

Emergency Contact Relationship

Code

Emergency Contact Phone

Home Address

Athlete Birthday

#1 Preferred Basketball Position

#2 Preferred Basketball Position

Code

Athlete Phone

Athlete Allergies and Medication

Passport Copy

Upload File

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Passport Number

Passport Expiry Date

Athlete is COVID Vaccinated

Yes

No

Number of COVID Vaccinations

Athlete Dietary Requirements

Yes

No

If yes, please list below.

Pre-Existing Health Conditions

ATC Academy Australian Office
Level 14
60 Carrington Street
Sydney NSW 2000
Australia

Email:

taylor.jones@atcacademy.com.au

Telephone:

+61 434 481 885

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