Talent OKC - Paralympic Athlete Identification
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Athlete Information
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| Name
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| Prefix
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| First
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| Last
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| Suffix
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| Email
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| Phone Number
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| Date of Birth
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DD/MM/YYYY
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| Place of Birth
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City, Country
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| US Passport
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If you are not eligible for a US passport you do not qualify for this talent identification program
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Dimensions
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| Standing Height
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| Weight (lbs)
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| Dominant Hand
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| Arm Span (inches)
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Middle finger to middle finger
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Sporting History
Section 2 asks about your past sporting history and achievements. This allows us to gain a better appreciation of your future potential.
Please complete the following, starting with the sport in which you have competed to the highest level and work backwards noting other sports you may have been involved with.
If your disability is AQUIRED, please indictate if your participation occurred before or after your injury.
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| Sport #1
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| Average number of hours of dedicated to training / competing per week
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| Age at which you first started
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| Number of years in sport
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| Best Competitive Level Attained
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| Injury was aquired
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| Team represented or competitive event when you attained this level
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Example: High School Basketball Team
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| Highest Achievement
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| Sport #2
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| Age at which you first started
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| Average number of hours of dedicated to training / competing per week
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| Number of years in sport
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| Best Competitive Level Attained
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| Injury was aquired
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| Team represented or competitive event when you attained this level
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Example: High School Basketball Team
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| Highest Achievement
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Additional Information
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| What information regarding your sporting history might we want to know to support your application (i.e. Captain, Most Valuable Player, record statistics etc.)?
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Medical History
In this section, you will be asked a series of questions regarding your medical history. This is in the interests of health and safety; further information may be required.
This talent identification program is specific to the requirements of a potential medal winning adaptive rower. Please answer all questions as honestly as possible.
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Your Disability
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| Please provide the medical term for your disability
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| Is your disability AQUIRED or CONGENITAL
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| If AQUIRED, how long have you had the aforementioned impairment?
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| Please provide a short description of your disability in lay terms:
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Your Ablilities
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| Can you sit upright, unaided?
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| IF NO, what form of assistance do you require?
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| Can you move from a lying to a sitting position unaided?
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| IF NO, what form of assistance do you require?
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| How much torso rotation do you have?
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Injuries
In addition to your impairment, we would like to know about any other injuries you may have (or have had) which would prevent you from participating in sport
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| Have you sustained any of these injuries
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Fraction Dislocation Muscle Strain / Tear Joint Sprain Hernia Concussion Other
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| Please provide more information about any of the selected injuries
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Location, date of injury - current, less than 6 months ago etc.
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Past Medical History
Please indicate if you suffer/have suffered from any of the following medical conditions.
Supply accurate information as if you are selected to attend a Phase 1 of the Talent Identification; we may not be able to assess you without these details.
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| Asthma
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| Diabetes
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| Heart Problems
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| Epilepsy
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| Any other medical condition for which you have seen a specialist
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| Details of Condition
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Family Medical History
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| Has anyone in your immediate family (parents, siblings, uncles or aunts) died under the age of 55 from a heart or circulation disorder?
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Talent Identification Sign up Information
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| If you are identified as a potential Paralympic athlete, would you consider training in Oklahoma City, OK?
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| How did you hear about the Talent OKC program?
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Newspaper Online University Military Gym Friend Parent Other
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Image Verification
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EMF Online Form
EMF Online Form