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Available on

Apple Android Windows

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.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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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.

  • Ico textbox

    Name

  • Ico textbox

    Sport

  • Ico date

    Date of Birth

  • Ico statictext

    STUDENT-ATHLETES SHOULD FILL OUT WITH PARENTS TO GUARANTE INFORMATION IS CORRECT

  • Ico statictext

    The Acknowledgement of Insurance Requirements must be read and understood.

  • Ico textbox

    Parent/Guardian Name

  • Ico textbox

    E-Mail Address

  • Ico multiline

    Address

  • Ico textbox

    Home Telephone #

  • Ico textbox

    Work Telephone #

  • Ico textbox

    Cell Telephone #

  • Ico textbox

    Policy Holder Name

  • Ico textbox

    Relation to Student-Athlete

  • Ico multiline

    Address

  • Ico textbox

    Home/Cell Phone

  • Ico textbox

    Work Phone

  • Ico textbox

    Insurance Company Name

  • Ico multiline

    Insurance Co.

  • Ico textbox

    Group #

  • Ico textbox

    ID #

  • Ico date

    Effective Date of Policy

  • Ico date

    Expiration Date

  • Ico textbox

    Primary Physician

  • Ico textbox

    Phone #

  • Ico textbox

    Policy Limit

  • Ico textbox

    Policy Deductible

  • Ico textbox

    Policy Co-Pay

  • Ico textbox

    Does this policy cover athletically related injuries?

  • ...and More!

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