2024 Össur + CAF Running and Mobility Clinic - Columbus

2024 Össur + CAF Running and Mobility Clinic - Columbus - Participant Registration

Date: Saturday, September 28, 2024

Time: 8:45am - 12pm

Location: Historic Crew Stadium, One Black and Gold Blvd., Columbus, OH 43211

Get Active. Be Empowered.

Learn practical ways to move better, easier and quicker with your prosthesis, in a supportive and encouraging environment
Improve your speed and balance
Practice leg-over-leg techniques
Learn how to move in multiple directions so you can do a variety of recreational activities
Discover training routines and sport-specific exercises
Individuals with lower limb difference of all ages and abilities welcome

Please note that this registration is for individuals with lower limb amputation/difference only. If you would like to volunteer, please visit our volunteer registration page here.

For questions, please contact campsclinics@challengedathletes.org.

Athlete Information

First Name

Last Name

Date of Birth

Gender

Ethnicity

Address

City

State/Province

ZIP/Postal Code

Country

Mobile Phone

Emergency Contact

Emergency Contact Phone

Emergency Contact Relationship to Participant

Are you an individual with a permanent physical disability?

Choose disability category

Choose primary diagnosis

Please list diagnosis

Please select level

How did you acquire your disability?

What is the date of disability? MM/DD/YYYY

Please list any secondary physical issues/limitations

Please provide a short bio

What is your mobility experience with prosthetic(s)?

What type/brand of prosthetics do you currently use?

Do you have any questions/comments for the coaches of this clinic?

What are your motivations in attending this clinic and/or your goals for this clinic?

How many CAF events have you attended before?

How did you learn about this event? Please choose the best option

Please explain

Have you ever received a grant from CAF?

T-Shirt Size (Unisex)

BY COMPLETING THIS FORM, YOU OPT IN TO SHARING YOUR INFORMATION WITH OUR TITLE SPONSOR, ÖSSUR

Opt out

I hereby certify that I am eighteen (18) years or older, or the parent/legal guardian of participant, and that I have read this waiver and release and I hereby do consent to the terms and conditions of the CAF Release of Liability and the CAF Participant Code of Conduct and the Össur Clinic Liability Waiver.
(Type full name to electronically agree)

Parent Name (if participant is under 18)

Contact Information