2022 Junior Nationals Support Team

Name*

First Last

Email*

Phone*

Mailing Address*

Street Address City State ZIP Code

Role at Junior Nationals *Check all that apply*

Classifier
Clinician/Educational Speaker
Local Official
Local Organizing Committee Member
Medical
National Official
National Support Team
Other

Please describe your role at Junior Nationals.*

Sport(s) you will officiate*

Archery
Para Powerlifting
Paratriathlon
Shooting
Swimming
Track & Field
Wheelchair Tennis

Shirt Size*

Anticipated Arrival Date*

Anticipated Departure Date*

Hotel Room Preference - I would prefer to room:*

Rooms are booked at double occupancy unless you opt to room alone. If you choose to room alone, you will incur half of the room cost for the duration of your stay.

Please list any food allergies or considerations.

Please list any special accommodations needed. (ie: ADA room, interpreter)

Required Forms and Certificates

In addition to attaching the items below, please complete the Move United Liability Waiver and Media Release linked at the top of this page.

I have clicked the link above and signed the Move United Liability Waiver.*

I agree

I have read and agree to adhere to the Move United Travel Policy (linked above for reference).*

I agree

I have read and agree to adhere to the Move United Code of Conduct (linked above for reference).*

I agree

SafeSport Certificate *Dated within 1 year of today's date

Accepted file types: pdf, jpg, Max. file size: 64 MB.