| Athlete's Name | Kelia Gomes |
|---|---|
| Athlete's Birth Date | 09/13/2008 |
| Entry Date | 11/04/2024 |
| Insurance Provider | bcbs |
| Insurance Policy Number | x59620 |
| Primary Contact Name | Eric Gomes |
| Primary Contact Email | Email hidden; Javascript is required. |
| Primary Contact Phone | (808) 783-7046 |
| Alt Contact Name | Sherri Gomes |
| Alt Contact Email | Email hidden; Javascript is required. |
| Alt Contact Phone | (808) 375-2489 |
| Please describe the athlete's allergies. | Peanut and all tree nuts |