Athlete Profile

Page 1 of 8

Closes 31 Mar 2025

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Surname *

Surname (Required)

Forename *

Forename (Required)

DOB (DD/MM/YYYY) *

DOB (Required)

Gender *

Gender (Required)

Country you represent *

(Required) Northern Ireland Ireland Great Britain

Occupation: Please tick which of the following you are involved with: *

(Required) School Student University Student Full time employment Part time employment Other

Home Address

Address (Required)

Postcode *

Postcode (Required)

Training Base address

If current address outside of NI please provide Home address here.

Mobile Number *

Mobile Number (Required)

Email Address (If U18 please provide a parent / guardian email address) *

Email Address (Required)

Emergency Contact Name *

Emergency Contact Name (Required)

Emergency Contact relationship to athlete *

Emergency Contact relationship to athlete (Required)

Emergency Contact Email *

Emergency Contact Email (Required)

Emergency Contact Mobile Number *

Emergency Contact Mobile Number (Required)

Emergency Contact Daytime Number

Do you have private medical insurance? Please tick as appropriate *

(Required) Aviva BUPA VHI Other No Cover Unsure

If you have private medical insurance please select the date on which it expires (DD/MM/YYYY)

private medical insurance please select the date on which it expires

Citizen Space from Delib