Utah Track Club Registration Form 2022

Utah Track Club Registration Form 2022
Athlete(s) Information
Athlete First Name *
Athlete Last Name *
Age *
Date of Birth *

Month Day Year
Date
Gender *

Male Female
Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Events *

Sprint Distance Field Events
Uniform - Included in Track Club Fee *
*Team sweats, parent t shirts, and parent jackets will be available to order the first week of practice.
Parent/Guardian Information
Parent First Name *
Parent Last Name *
Parent Email *
example@example.com
Parent Phone # *

Area Code Phone Number
What talents do you have that could help the track club?
Medical Health *

To the best of my knowledge, there are no physical or other conditions, which will interfere with my child's participation. I certify that my child/ward has had a medical examination within the last 12 months and, in the physician's opinion, is physically capable of completing the sports for which he/she has registered
Signature *
Today's Date *

Month Day Year
Date
Emergency Contact
Name *

First Name Last Name
Relationship to Athlete *
Email *
example@example.com

Utah Track Club Fee *

Registration Club Fee $ 135.00

Total $ 0.00

A $25 USATF Membership fee is required for your child to be eligible for USA Track and Field meets. After you submit the UTC registration below, you will be directed to a 'Thank you' page with a link to renew or get a new membership. You may also click here to visit the USATF page now.

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Comments/Concerns
Should be Empty:

Athlete(s) Information