SJTFC Summer Track & Field Camp Registration Form

Summer Track & Field Camp (Rising 1st through 8th Grade)

PLEASE NOTE: We expect this program to reach capacity quickly. Please help us plan appropriately by registering as soon as possible. We will very likely be closing registration in early June.

Program Overview:

Dates: June 27-June30, and July 5-July 8 (This is one camp session, but is broken up by the July 4th holiday)

Times: 8:00am to 9:30am, except for the Summer Finale Track Meet on July 8 which will start at 6:00pm (the meet may be held at a different nearby high school).

Location: Haddon Heights High School, 301 2nd Ave, Haddon Heights, NJ 08035

Fee: Tiered Fee Options

Reduced Fee: $125 (for families that could use a little financial assistance, or for mutli-child discount
Standard Fee: $150 (what we need on average to deliver a quality program)
Supporters Fee: $175 (help us achieve our mission of providing access to all kids regardless of financial means)
We also offer free and reduced fees for families that participate in the free and reduced school lunch program (additonal info below)

Our Summer Track & Field Camp is an excellent way to introduce your young athlete to all of the events that make up the sport of track and field. It is also a great continuation of the spring season, and jump start to summer competition for the motivated athlete. Fun is the name of the game, as our dedicated coaches and volunteers follow an organized plan geared to get your child moving in many complex ways, promoting the physical development that will support a lifetime of health, fitness and well-being. The first week includes three instructional sessions and a “mini meet” that provides appropriate competition. The second week includes three more instructional sessions, and then we conclude the program with our annual Summer Finale Track Meet on the evening of July 8th.

To set up an annual membership for one or more children, please switch to the Annual Membership Form.

Athlete Information

Athlete's Name *

First Name Last Name

Athlete's Gender (M or F Required for AAU Membership) *

Male Female

Birth Date *

Month Day Year

Grade

Leave blank if under 1st. Rising grade if registering during the summer

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Parent/Guardian Information

Name *

First Name Last Name

Home Number *

Area Code Phone Number

Cell Number *

Area Code Phone Number

E-mail *

Emergency Information

Emergency Contact's Name *

First Name Last Name

Relationship (please select) *

Phone Number *

Area Code Phone Number

Alt. Phone Number

Area Code Phone Number

Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.

Is the athlete prescribed an inhaler? If yes, please explain any instructions.

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by South Jersey Track & Field Club during the selected camp. In exchange for the acceptance of said child’s candidacy by South Jersey Track & Field Club., I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless South Jersey Track & Field Club. and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against South Jersey Track & Field Club. including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including basketball. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

Medical Release and Authorization

As Parent and/or Guardian of the named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to the South Jersey Track & Field Club. and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered season. For personal coaching the release is ongoing as long as services are provided.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

Medical Release and Authorization Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Full Name *

Photo and Video Permission to Share

SOMETIMES WE CAPTURE GREAT MOMENTS OF THE KIDS PRACTICING, COMPETING, AND JUST HAVING A GREAT TIME TOGETHER, AND WE LOVE SHARING THESE PHOTOS VIA OUR SOCIAL NETWORKING PAGES, CLUB EMAILS, CLUB WEBSITE, ETC. IF YOU EVER SEE A PHOTO POSTED THAT INCLUDES YOUR CHILD AND YOU WOULD PREFER THAT IT BE REMOVED FROM ANY OF THE ABOVE LOCATIONS SIMPLY LET US KNOW.

PHOTO VIDEO PERMISSION *

I agree that any pictures, videos, and/or results resulting from the program hours or team competition may be used for future promotional purposes, press, releases, and public information. I will contact SJTFC if I would like to request that a specific photo or video be removed from any location.

Program and Payment Options

To keep registration organized we prefer credit card payment here, but you may also submit this form without payment, and then pay with Venmo. Credit card transactions are safely processed by Square (www.squareup.com).

Refunds

IN GENERAL, PROGRAM FEES ARE NON-REFUNDABLE. WE PLAN ALL OF OUR PROGRAMS AROUND THE TOTAL NUMBER OF CHILDREN REGISTERED, SO IT CAN BE DIFFICULT TO PROVIDE REFUNDS, BUT WE WILL MAKE EXCEPTIONS TO THE POLICY WHEN POSSIBLE. IF AN ENTIRE PROGRAM IS CANCELED WE WILL REFUND THE PROGRAM FEE, MINUS THE BANK SERVICE CHARGE, AND ANY COSTS INCURRED BY THE CLUB (I.E. ACCESS FEES THAT HAVE BEEN PAID AND NOT REFUNDED).

REFUNDS *

I understand that program fees are NON-REFUNDABLE.

Reduced Fee For Families That Qualify

In additon to our tiered program fees, we offer a reduced fee for families that qualify. Select the appropriate option here, upload a copy/screenshot of your free or reduced lunch confirmation, and submit this form with payment information below left blank. (Do not click on any program options.) A club representative will contact you as soon as possible to discuss minimum program fees. If you do not have access to free and reduced lunch forms, please contact Craig Strimel through the club website.

Does your child qualify for a free or reduced lunch program?

Yes No

Upload free or reduced lunch confirmation from your child's school district.

Browse Files

Payment Choice *

Credit Card Venmo (see link below, and a link will be provided in a receipt email) Annual Membership (If you have not already done so, you must also fill out the annual membership form. A link to that form will be emailed to you when you submit this form.)

Venmo: Scan or click the image below, or search @strimelconsulting

If paying via Venmo, click, scan or search this account.

***If paying via Venmo, be sure to enter your child's t-shirt size as a note (YS, YM, YL, AS, AM, AL). We are past the deadline to guarantee a uniform t-shirt but will do our best with the extras we ordered.)

Program Fees and Payment

Summer Track & Field Camp $ 150.00

Variable Options T-shirt Size (we are past the deadline to guarantee a uniform t-shirt but will do our best with extras we ordered.)

Summer Track & Field Camp - 1 Week Only $ 90.00

Session T-shirt Size (we are past the deadline to guarantee a uniform t-shirt but will do our best with the extras we ordered.)

Additional Donation Free

Enter Donation Amount Here

Enter coupon

Total $ 0.00

Credit Card

South Jersey Track & Field Club is a New Jersey Benefit Corporation

www.southjerseytfc.com

South Jersey Track & Field Club

Enter Your Child's Information to Register Now

Continue below if paying by credit card

Credit Card