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Declaration of Interest for the Pan Am Games Team
USA Taekwondo will hold an open team trials for poomsae athletes trying out for the Pan Am Games in poomsae in June 2019 (exact date and location TBD). For more information regarding the team trials format, please see https://www.teamusa.org/usa-taekwondo/v2-national-teams/team-selection-procedures. Please note that this form is only for those athletes who intend to compete as part of a 5-person freestyle team.
Due to the organizational requirements of the Pan American Sports Organization (PASO) and Pan American Games, USA Taekwondo requires that all athletes interested in competing at the June Pan Am Games Poomsae Team Trials to submit their information at the form below by March 15, 2019. Failure to submit interest may result in ineligibility for the Pan Am Games Team Trials. There is no commitment to compete implied by the completion of this form.
Athlete First Name
Athlete Middle Name
Athlete Last Name
Athlete Birthday
MM
/
DD
/
YYYY
Athlete USATKD Membership Number
Athlete GAL Number
Athlete Gender
Male
Female
Athlete Phone Number
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-
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-
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Athlete Email
List of names of 4 other teammates on 5-person team:
Include First, Last, & Middle Names, USATKD Membership Number, GAL Number, Gender, & Birthday
Athlete #2
Athlete #3
Athlete #4
Athlete #5
Athlete Coach First Name
Athlete Coach Last Name
Athlete Coach Phone Number
###
-
###
-
####
Athlete Coach Email
Team name (athletes may choose any name, for identification purposes only):
Do Not Fill This Out
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