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Team Iowa Collage


Please com­plete this appli­ca­tion form if you are inter­est­ed in par­tic­i­pat­ing in Team Iowa. ALL Team Iowa mem­bers must com­plete the form, includ­ing minors.

For Team Iowa pro­gram ques­tions, please con­tact Anna Hobart, Team Man­ag­er, at 5157277897 or ahobart@​iadn.​org.

* required field

Personal Information

(please select all that apply)
Profiles will be shared on the IDN Team Iowa Directory Page. IF NO PHOTO IS UPLOADED and you give Authorization to use a photo in the below question, the Team Iowa Manager will select a photo from our files.


Education / Employment



Personal Background Information

(A conviction record will not necessarily bar team membership. Factors such as age of the offense, seriousness and nature of the violation and rehabilitation will be taken into account.)


Emergency Contact Information



Your Connection to Donation

Please fill in the below information based off your connection to donation. If question is not applicable to you put N/A.

(RECIPIENT)
(RECIPIENT or LIVING DONOR)
(RECIPIENT or LIVING DONOR)
(DONOR FAMILY or SUPPORTER)
(DONOR FAMILY or LIVING DONOR)
(SUPPORTER or LIVING DONOR)
(DONOR FAMILY or RECIPIENT)
(DONOR FAMILY or LIVING DONOR)
(DONOR FAMILY or LIVING DONOR)


Team Membership Type and Responsibilities

Competitor

Solid Organ Recipients, Living Donors, Bone Marrow Recipients, Cornea Recipients and Tissue Recipients ONLY. At least 9 months post-transplant by June 2024. Competitors must raise $750 and attend all Team Meetings.

Non-Competitor

Donor Families, Supporters, Fans, Sponsors and anyone who is not competing. Non-competitors will receive a free Team Iowa t-shirt. Additional items will be available to purchase. 



Previous Games Experience



Team Iowa Membership Agreement

I understand and agree to the following terms:

  1. I certify that the information provided in this application is true and correct in all respects without any willful omissions.
  2. I understand that I will be screened at Iowa Donor Network's cost for a background check. The background investigation shall include, but is not limited to: Motor Vehicle Records Check, Social Security Trace, Child Abuse Registry Check, Criminal History Check, Education Verification and/or employment verifications. A positive finding for any of the above, such as a conviction or court-imposed penalty for a crime, may preclude me from consideration as a member of Team Iowa. If I have already completed a background check for Team Iowa, I am required to notify the Team Manager if I should be convicted of a crime or violation after the date of my original background check.
  3. I will adhere to Team Iowa's Code of Conduct and Ethics which will be provided to me in detail upon joining the team.
  4. I understand that I am required to provide proof of medical clearance from my physician two months prior to the Transplant Games in June 2024 in order to participate in any events.
  5. I agree to fulfill the fundraising requirements as a member of Team Iowa.

Our Vision:

All are inspired to donate life.