NSATA/NSAA Event Reporting

Please complete the following information, and submit following each NSAA Championship event. Note, if you login with your username and password some fields will automatically populate for you!

First Name *

Last Name *

Residential Address *

City *

State *

Zip Code *

Cell Phone *

Email Address *

NATA Member Number *

BOC Number

NE License Number *

Sport

Hours

Venue

Date

Arrival

Departure

Add Remove

Please briefly note the school name and name(s) of any medical or allied healthcare provider who accompanied any teams during your assigned event. i.e. MD, ATC, PT, other.

Please briefly note any comments on NSATA arrangements for NSAA Championship coverage, or any problems or issues you encountered:

Please limit to 100 words or less

reCAPTCHA

To make sure you are a human filling out this form, in order to submit successfully, you will need to enter the CAPTCHA above.

Agreement

By submitting this form, I acknowledge and attest that I am a current NATA Member, a member in good standing of the BOC, and am currently licensed to practice athletic training in the state of Nebraska. I further understand that failure to comply with any of these requirements nullifies any liability insurance that the NSATA has secured on my behalf and that I will be responsible for any and all legal claims that may be brought against me, and subsequent damages that may be awards for any acts occurring while providing athletic training services for the NSATA at NSAA Championship events. I further understand that failure to comply will lead to the forfeiture of any and all hours that would otherwise be applied to apparel packages or payment that would otherwise be provided by the NSATA for providing athletic training services at NSAA Championship Events.