Athlete Information
Name
*
First Name
Last Name
School
*
2024/2025 School Year
Grade
*
Please Select
7
8
9
10
11
12
Post H.S.
2024/2025 School Year
Gender
*
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Boy
Girl
Birth Date
*
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1
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31
Day
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Year
Current USATF Number
*
https://usatf.sport80.com/public/wizard/a/941/home
Potential Events
*
Sprints (100/200/400)
Mid-Distance (400/800)
Distance (1600/3200)
Hurdles
Long / Triple Jump
High Jump
Shot / Discus
Uniform Rental
*
Yes
No
Uniform Size - Top
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Adult XS
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Uniform Size - Bottom
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Adult XS
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Address
Street Address
Street Address Line 2
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Postal / Zip Code
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Afghanistan
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Country
Parent / Guardian Information
Parent / Guardian #1's Name
*
First Name
Last Name
Parent / Guardian #1's Phone Number
*
-
Area Code
Phone Number
Parent / Guardian #1's E-mail
*
Parent / Guardian #2's Name
First Name
Last Name
Parent / Guardian #2's Phone Number
-
Area Code
Phone Number
Parent / Guardian #2's E-mail
example@example.com
Waiver, Release, and Statement of Physical Release
In consideration of the participation of my child, noted above, in the Millard South Track and Field Club, I, in my own right and as next friend of such minor child, for myself and for such minor child, our heirs, successors, administrators and assigns, hereby contractually waive, relinquish and release any and all rights, claims, actions and/or causes of action we may have against the Millard South Track and Field Club, club board of directors and officers, and/or any volunteer assistant coach or other club personnel for personal injury or property damage arising from, or in any way connected with, the Millard South Track and Field Club/Program during the 2024-2025 calendar years. I further certify that the minor child named above is granted my permission to participate in the Millard South Track and Field Club/Program. I am aware of the intensity of the training and competition involved and the associated risks, and I certify that such child is physically fit to participate in such program. I further certify that I know of no physical condition or impairment that would in any way prevent such child from participating in the program. I further understand that, with my child’s membership, I assume the responsibility of helping with the competitions that the club organizes in whatever capacity for which I am qualified.
Signature
*
Questions or Comments
Payment
*
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