Name:

Mobile Number:

Father’s NameFirst Name & Middle Name (If applicable)

Date of Birth:MonthDay

School:

Medical Concerns:

Blood Type:

Electrocardiography Test (ECG):

Kit Size: Small Medium Large

A+ A- B+ B- AB+ AB- O+ O-

Contact Person: Mobile Number:

PERSONAL INFORMATION

MEDICAL INFORMATION

EMERGENCY INFORMATION

APPLICATION

Completed Not Completed

Signature: Date:Day Month Year

Family Name

Year

The application should be submitted at the Athletics Office, Beirut campus (Gymnasium Building)

REQUIRED DOCUMENTS

• Two colored passport-size photos• Photocopy of the ID