LA2028 Form Test - Paralympics New Zealand

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Personal details

Email*

Phone*

Region*

Occupation*

Gender*

Please tell us your gender

Preferred gender pronouns

Please tell us your preferred gender pronouns

Do you have another cultural identity or identities?

E.g., Samoan, Chinese, Scottish etc.

What is your iwi affiliation? (if known)

What is your hapu? (if known)

What is your marae? (if known)

Schools attended

As part of the development of PNZ Education Programme we would appreciate it if you could confirm the schools/tertiary providers you have attended

Primary school(s) attended

Intermediate school(s) attended

Secondary school(s) attended

Tertiary / University attended

Dietary

Other dietary requirement

Other allergies*

Social media

Instagram handle

If you have an athlete Instagram, please enter the handle as it appears on your account

Facebook page

If you have an athlete Facebook page, please enter the URL

TikTok

If you have an athlete TikTok account, please enter the username

Other profiles

Please include information about any other social media athlete accounts you have (e.g., YouTube, Twitter/X, website etc.)

Medical practitioner

Doctor's medical clinic*

Doctor's phone number*

Passport and travelling details

Individuals must have a valid New Zealand passport with more than six months until expiry upon the date of entry into Italy.

Passport number*

Place of birth*

Attach a copy of your passport

Accepted file types: jpg, png, pdf, jpeg, bmp, docx, psd, tif, Max. file size: 50 MB.

Please advise details including dates and country visited

Membership airline

Membership number

Membership status

E.g. Gold, silver, bronze etc.

Disability information and requirements

What is your Para sport classification?

What assistance do you require?

Emergency contact details

Email

Phone

Relationship

E.g., mother, friend, husband, sister, carer etc.

Email

Phone

Relationship

E.g., mother, friend, husband, sister, carer etc.

Clothing sizing

Top size

Pants size

Shoe size

US sizing

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Event

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Los Angeles 2028 Paralympic Games - Athlete Personal Details Form

Personal details

Schools attended

Dietary

Social media

Medical practitioner

Passport and travelling details

Disability information and requirements

Emergency contact details

Clothing sizing

Official Partners

Community Partners

Media Partners

High Performance Delivery Partner

Team Supporters

Official Suppliers

Funding Partners