TRACKIE - Online registration for events, tournaments, clubs and organizations...

Are you a new or renewing member? *

First Name *

Last Name *

Gender on Passport *

Male Female

Date of Birth (YYYY *-MM-DD)

/ /

Team - Is yours missing?

Club Instructor's Name *

Club Instructor's Email *

Additional Coach's Name (optional)

Additional Coach's Email Address Opt in to emails

Zone *

Athlete's Street Address *

City *

Postal Code *

Phone Number * - International Number

Contact Email for Athlete (Please ensure this email is correct as all BC Team correspondence will go to this email and will be deemed to have been received if sent to this email) * Opt in to emails

BC Care Card Number *

Photo (headshot) *

Parent/Guardian's First Name *

Parent/Guardian's Last Name *

Parent/Guardian's Email *

Emergency Contact Name *

Emergency Contact Relationship to Athlete *

Emergency Contact Phone * - International Number

Additional Email #1

Additional Email #2

Additional Email #3

I am a *

Year 1 Goals *

Year 2 Goals *

Year 3 Goals *

My technical strengths: *

My technical weaknesses: *

My tactical strengths: *

My tactical weaknesses: *

My physical strengths: *

My physical weaknesses: *

Psychology *

Nutrition *

BC Medical Service Plan (MSP) Number *

1. Are you medically fit enough to compete in a karate competition? *

2. Do you have any joint injuries still healing? *

3. Do you have any allergies or anaphylactic reaction? *

4. Have you had a head injury (concussion) within the last 6 months? *

a. If yes, what was the date you were officially by a medical doctor cleared to return to compete in karate competitions?

b. Are you still currently suffering from any symptoms?

c. Are you back to training at the same competition ability level as before your concussion?

5. List any medications

6. List any fractures, orthopedic surgery, disease or disability that the tournament medical staff need to know before you compete in this karate tournament:

Confirm Name of Competitor *

Confirm Name of Parent/Guardian (if competitor is under 19 years of age)

Do you consent to KBC sharing you contact information with CSI Pacific if you are recommended for carding? *

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Division

Division *

Category *

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I have read and agree *
Consent Waiver

I have read and agree *
Athlete Agreements and Code of Conduct

Typed digital signature (type your name exactly as entered above "registrants name") *

2027 BC Team Prospect Registration - May Nationals

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