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Student Athlete Emergency Contact Information Mobile App

Use this mobile application to quickly fill out and submit emergency contact and insurance information for the student athlete. This facilitates quick and effective communication during emergency situations. Parents and students can acknowledge and verify data by signing off from the app. When the user completes this app, GoCanvas will automatically store the user's information in their account in a secure location in the GoCanvas Cloud, or email a PDF. Users can access their data anytime from the GoCanvas Cloud.

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Take a peek inside the Student Athlete Emergency Contact Information Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

Name
Sport
Date of Birth
STUDENT-ATHLETES SHOULD FILL OUT WITH PARENTS TO GUARANTE INFORMATION IS CORRECT
The Acknowledgement of Insurance Requirements must be read and understood.
Parent/Guardian Name
E-Mail Address
Address
Home Telephone #
Work Telephone #
Cell Telephone #
Policy Holder Name
Relation to Student-Athlete
Address
Home/Cell Phone
Work Phone
Insurance Company Name
Insurance Co.
Group #
ID #
Effective Date of Policy
Expiration Date
Primary Physician
Phone #
Policy Limit
Policy Deductible
Policy Co-Pay
Does this policy cover athletically related injuries?
...and More!