Club Sports :: Members

Login Information

Select a Username:*

Select a Password:*

Verify Password:*

Personal Details

First Name:*

Middle Initial:

Last Name:*

Date of Birth:*
(Month DD, YYYY)

,

Hometown:*

Home State:*

Emory University Information

Emory E-mail:*

Emory Personal ID Number:*

Emory PO Box:

Dormitory:

Dorm Room:

Campus Telephone:

- -

Cellular Telephone:

- -

What year did you enter Emory?*

What year will you graduate?*

Permanent Contact Information

Street Address 1:*

Street Address 2:

City:*

U.S. State:*

Province:

ZIP Code:*

-

Other Postal Code:
(If applicable)

Country:*

Home Telephone:*

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Communication Preferences

Include me in the online member/alumni directory:*

Club Memberships

I am a member of or interested in the following club sports:*

	Badminton
	Crew
	Cricket
	Cycling & Triathlon
	Equestrian
	Fencing
	Field Hockey
	Gymnastics
	Men's Lacrosse
	Men's Rugby
	Men's Ultimate
	Roller Hockey
	Sailing
	Squash
	Table Tennis
	Volleyball
	Weightlifting
	Women's Lacrosse
	Women's Rugby
	Women's Ultimate
	Women's Water Polo

Emergency Information

Emergency Contact Name:*

Relationship:

Emergency Contact Telephone:*

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Medical Conditions:

Allergies:

Diet Type:

Other Diet Information:

Biographical Information

Brief Biography or Quotations:
(Included in the member/alumni directories)