2023 NYC Championships 2023 National Youth Championships (NYC) Player Information Name(Required) First Last Date of Birth MM slash DD slash YYYY Representative Team(Required)State Team Girls Under 14'sState Team Girls Under 16'sState Team Boys Under 16'sState Team Boys Under 15'sEmergency Contact 1 Emergency Contact 2 Emergency Contact Email 1 Emergency Contact Email 2 Emergency Contact Phone 1 Emergency Contact Phone 2 Will a Parent/Guardian be attending the tournament? Yes No Name of Parent/Guardian 1 First Last Parent/Guardian Phone NumberHeadaches / Migraine(Required) Yes No Asthma / Bronchitis(Required) Yes No Allergies(Required) Yes No Type of Allergies Medical Details(Required) Yes No Medical information Name on Medicare Card Position (IRN)Medicare NumberPrivate Health Insurance Provider Position (IRN)Member NumberDate of Last Tetanus Vaccination Will the player require medication during the trip? Yes No Details of MedicationDietary RequirementsPlease provide any further info you feel will be of assistance