OBSA Membership "*" indicates required fields OBSA Membership Price: Member Status* New Renewal Personal InformationFirst Name* Middle Initial Last Name* Gender* Male Female Other Date of Birth* Month Day Year Mailing AddressStreet* Apartment # City* Postal Code* Email* Primary Phone* Secondary Phone Membership TypeMembership Affiliation* Athlete Coach Official Volunteer Support Other Indicate Sports* Goalball Athletics Judo Powerlifting Wrestling Swimming Other Do you belong to a Sports club?Provide information on your club belowHealth & Emergency InformationHealth Insurance Number Health InformationAllergies, any other medical concerns.Emergency Contact Person* Emergency Contact's Primary Phone Number* Emergency Contact's Secondary Phone Number Relationship to Emergency Contact ConsentI consent to comply with the OBSA Governing Documents.* Yes I consent.I agree to the Terms of the Waiver and Release of Liability.*If 18 or under a parent/guardian with legal responsibility for this participant must complete. Yes I agree.I agree to the Use of Personal Information and Photo Release.* Yes I agree.I have read, understood, and agree to the Concussion Awareness Resources and Code of Conduct.* Yes I agree.PaymentPayment Method* Cheque PayPal PayPalTo get started, please configure your PayPal Checkout Settings.PhoneThis field is for validation purposes and should be left unchanged.