Athlete Profile

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Closes 1 May 2023

Athlete Profile

Athlete Profile

Surname *
Forename *
DOB (DD/MM/YYYY) *
Gender *
Place of Birth *
If POB outside NI how do you meet criteria to represent NI?
Country you represent *
(Required)
Occupation: Please tick which of the following you are involved with: *
(Required)
Please state the educational course or field of work that you are involded in:
Address *
City / Town *
County *
Postcode *
Mobile Number *
Email Address *
Athlete Facebook page
Athlete Twitter account
Emergency Contact Name *
Emergency Contact relationship to athlete *
Emergency Contact Email *
Emergency Contact Address *
Emergency Contact Mobile Number *
Emergency Contact Daytime Number
Do you have private medical insurance? Please tick as appropriate *
(Required)
If you have private medical insurance please select the date on which it expires (DD/MM/YYYY)
GP Name *
GP Address