SJTFC Annual Membership Registration

South Jersey Track & Field Club

Annual Membership Subscription
ATTENTION: This form is only for setting up an Annual Membership. If you want to register for only one program click on its link here.

You can read about all of our programs on the regsitration form for each individual program:
Annual Membership Details

An annual membership with SJTFC is agreat way to support the ongoing mission of the club, as it allows us to plan more effectively. It also keeps you from having to remember to sign your child up for each program. You will automatically be set up for all program email updates, and your child will always be guaranteed a spot in each program.

Annual Membership Fee

Total Fee (if made in one annual payment): $399.00

Monthly Subscription Option:

$35.00 per month, three months paid in advance, then monthly until you cancel.

Family Discount:

1st Child: $35 per month ($420 per year)

2nd Child: add $30 (Family of 2 pays $65 per month, $760 if one annual payment)

3rd Child: add $25 (Family of 3 pays $90 per month, $1050 if one annual payment)

Additional Children: add $20 each (Family of 4 pays $110 per month, $1250 if one annual payment)
Please enter the number of children you are registering for an annual membership *
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
2nd 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
3rd 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
4th 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
5th 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
Do any of the children listed have any allergies, chronic illness, or medical conditions? If yes, please describe and indicate child's name.
Are any of the children listed prescribed an inhaler? If yes, please indicate which child/ren) and 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.
Refunds

IN GENERAL, PROGRAM FEES ARE NON-REFUNDABLE. FOR ANNUAL MEMBERSHIPS, THE MONTHLY FEE IS NON-REFUNDABLE ONCE IT IS PROCESSED. YOU MAY CANCEL YOUR MEMBERSHIP UP TO ONE WEEK BEFORE A PENDING PAYMENT BY SENDING AN EMAIL TO CRAIG@SOUTHJERSEYTFC.COM.
REFUNDS *

I understand that once paid, the monthly subscription fee is NON-REFUNDABLE.
Payment

After submitting this form you will receive an invoice for an initial payment. Membership begins on the day payment is processed, or on the first day of the next program or event on our calendar. After three months you will receive an invoice for a monthly recurring payment.
Choose your payment option

One payment of $399 Monthly payments
South Jersey Track & Field Club is a New Jersey Benefit Corporation

www.southjerseytfc.com
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