| Athlete's Name | Audrina Block |
|---|---|
| Athlete's Birth Date | 06/01/2013 |
| Entry Date | 08/15/2026 |
| Insurance Provider | Blue Cross Blue Shield |
| Insurance Policy Number | CCV581A24811 |
| Primary Contact Name | Kaela Block |
| Primary Contact Email | Email hidden; Javascript is required. |
| Primary Contact Phone | (701) 509-2956 |
| Alt Contact Name | Josh Block |
| Alt Contact Email | Email hidden; Javascript is required. |
| Alt Contact Phone | (701) 509-1379 |
| Please describe the athlete's allergies. | Food allergies to peanuts, tree nuts and oats. Can be around them, just can’t eat them. |