www.translpantteamireland.wordpress.com Athlete Database 100% of survey complete. Question Title * 1. Please fill in your details below: Name: Address 1: Address 2: City/Town: County Mobile Number: Email Address: Age: Question Title * 2. Are you a transplant recipient or are you on dialysis? Transplant Recipient On Dialysis Please indicate the type of transplant or the type of dialysis: Kidney Liver Heart Lungs Pancreas Kidney/Pancreas Kidney/Liver Heart/Lung Other (please specify) Please indicate the type of transplant or the type of dialysis: Transplant Recipient menu Hospital based haemodialysis Commercial haemodialysis unit Home based haemodialysis Peritoneal dialysis (CAPD) Peritoneal dialysis (APD) Please indicate the type of transplant or the type of dialysis: On Dialysis menu Other (transplant) *please specify* Question Title * 3. What year did you start dialysis / receive your current transplant? Year starting dialysis Year of transplant Indicate the year you started your CURRENT treatment (either Dialysis OR Transplant) 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 Indicate the year you started your CURRENT treatment (either Dialysis OR Transplant) Year starting dialysis menu 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 Indicate the year you started your CURRENT treatment (either Dialysis OR Transplant) Year of transplant menu Question Title * 4. Please indicate the sports in which you have previous experience: Athletics (track - middle & long distance) Athletics (track - sprints) Athletics (field - throwing events) Athletics (field - jumping events) Badminton Cycling Darts Golf Petanque (French Boules) Road Running Squash Swimming Table Tennis Tennis Ten Pin Bowling Question Title * 5. Please indicate the sports in which you have little or no experience but would like to try: Athletics (track - middle & long distance) Athletics (track - sprints) Athletics (field - throwing events) Athletics (field - jumping events) Badminton Cycling Darts Golf Petanque (French Boules) Road Running Squash Swimming Table Tennis Tennis Ten Pin Bowling Question Title * 6. Have you competed in any transplant/dialysis Games before? 2013 - World Transplant Games - South Africa 2012 - European Transplant & Dialysis Games Croatia 2011 - World Transplant Games Sweden 2010 - European Transplant & Dialysis Games Ireland 2009 - World Transplant Games Australia 2008 - European Transplant & Dialysis Games Germany 2007 - World Transplant Games Thailand 2006 - European Transplant & Dialysis Games Hungary 2005 - World Transplant Games Canada I have other competition experience (Please specify below) I do not have competition experience Other competition experience (please specify) Done