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Injury Prevention Program Registration

To register for any of Nationwide Children's Sports Medicine 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.

Registration Form
Athlete's First and Last Name: *
Male/Female: *
Male
Female
Age: *
Grade Entering in Fall: *
School: *
T-shirt Size: *
Program(s) Registering for Fall 2010 - Winter 2011 *
ACL Bootcamp – All sports (Sept. 13 – Oct. 20)
Shoulder Stability Program (Jan. 10 – Feb. 16)
Strength and Power Program – All sports (Sept. 14 – Oct. 21)
Strength and Power Program – All sports (Jan. 11 – Feb. 17)
Speed and Agility Program – All sports (Nov. 2 – Dec. 14)
Speed and Agility Program – All sports (March 1 – April 7)
Your Name: *
Your Relationship to Athlete: *
Street Address: *
City: *
Zip Code: *
Phone (ex. 888 8888888): *
E-mail Address: *
How did you hear about us? (check all that apply) *
Athletic Director
Athletic Trainer
Coach
Physician
Nurse
Parent
Friend
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Other