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Personal Best Injury Prevention Program Registration

To register for any of Nationwide Children's Sports Medicine Personal Best Injury Prevention Programs, please complete the following two steps:

  1. Complete and submit our online registration form below. After submitting, a Nationwide Children's Sports Medicine Team member will contact you within one business day to confirm your registration.
  2. Download our release form here. You must bring a signed copy of this form to your first session to be able to participate.

If you have any additional questions, please call (614) 355-6013.
 


Personal Best Registration Form
  1. Athlete's First and Last Name:*

  2. Male/Female:*

  3. Age:*

  4. Grade Entering in Fall:*

  5. School:*

  6. T-shirt Size:*

  7. Program(s) Registering for Fall 2009/Winter 2010:*

  8. Your Name:*

  9. Your Relationship to Athlete:*

  10. Street Address:*

  11. City:*

  12. Zip Code:*
        

  13. Phone (ex. 888 8888888):*
          

  14. E-mail Address:*

  15. How did you hear about us? (check all that apply)*