STUDENT ATHLETE CONTACT



CATAWBA COLLEGE STUDENT-ATHLETE SUMMER CONTACT FORM

PLEASE PRINT NEATLY

NAME: _____________________________________________ SPORT: ___________________________

Home Address: ____________________________________________________

____________________________________________________

_____________________________________________________ ____________________

City State ZIP

SUMMER Address if different then above: _____________________________________________________

_____________________________________________________

_____________________________________________________________

City State ZIP

Please list any and all dates and corresponding locations during the summer in which you will not be at the summer address listed above. Use back side of this form or an additional sheet if necessary:

Dates:_________________________ Location:_______________________________________

Dates:_________________________ Location:_______________________________________

Your Home Phone #: ( ) ______________________ Your Cell Phone #: ( ) ________________________

Your Summer Phone # (if different than home phone number): ( ) ___________________________

Your Summer or BEST E-mail Address to contact you: _____________________________________________________

Name and Phone Number of an Emergency Contact Person in the event we can’t reach you directly:

Name: _________________________________________ Relationship:______________________________

Emergency Contact’s Phone #: ( ) ___________________________

Summer Employment: ________________________________________ Phone #: ( ) ________________________

Summer School Class and/or Work Schedule:

|SUNDAY |MONDAY |TUESDAY |WEDNESDAY |THURSDAY |FRIDAY |SATURDAY |

| | | | | | | |

| | | | | | | |

| | | | | | | |

| | | | | | | |

Summer Sports League if applicable: _______________________________________________________

Name of Team: _______________________________________ Location:_____________________________________

Coach Name: _________________________________________ Coach Phone #: ( ) _____________________

** Should any changes occur in the contact information noted above please notify all of the following:

Dennis Davidson – Athletic Director 704-637-4474 DDAVIDSO@CATAWBA.EDU Craig Turnbull -Compliance Coordinator 704-637-4475 CTURNBUL@CATAWBA.EDU

Bob Casmus, ATC – Head Athletic Trainer 704-637-4350 BCASMUS@CATAWBA.EDU

YOUR HEAD COACH

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