Membership Application Form

Calgary Warriors Track Club

Membership application for the 2019-2020 Season
Club Information & Fees *
Informed Consent *
Anti-Doping Program *
Code of Conduct and Ethics *
Athlete Name *

First Name Last Name

Athlete Street Address *

Street Address
Street Address Line 2
City or Town	Province
Postal Code	Country

Athlete Gender *

Female Male
Athlete Email Address
Athlete Home Number *

Area Code Phone Number
Athlete Cell Number

Area Code Phone Number
Athlete Date of Birth *

Month Day Year
Athlete School Name *
Current Grade *
Preferred Events
Athlete Citizenship *
Required by Athletics Alberta
Athlete Country of Birth *
Required by Athletics Alberta
Alberta Health Care Number
Name of 1st parent or guardian *

First Name Last Name

Street Address of 1st parent or guardian (required only if different than athlete address)

Street Address
Street Address Line 2
City or Town	Province
Postal Code	Country

Email Address of 1st parent or guardian *
Phone Number of 1st parent or guardian *

Area Code Phone Number
Work Number of 1st parent or guardian

Area Code Phone Number
Name of 2nd parent or guardian

First Name Last Name

Street Address of 2nd parent or guardian (required only if different than athlete address)

Street Address
Street Address Line 2
City or Town	Province
Postal Code	Country

Email Address of 2nd parent or guardian
Phone Number of 2nd parent or guardian

Area Code Phone Number
Work Number of 2nd parent or guardian

Area Code Phone Number
Signature of parent or guardian *
Enter full legal name
Signature date *
Should be Empty:

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