Athlete Name
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First Name
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Date of Birth
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Month
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Day
Year
Date
Athlete's grade
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Parent Email Address
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example@example.com
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Address
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Does the athlete have any chronic medical illnesses such as diabetes, asthma (exercise asthma), kidney problems, etc.?
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Parent/Guardian & Emergency Contact
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I, the athlete, agree with the following statements:
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I am physically able to take part in the activities.
I know there is a risk of injury. I understand the risk of continuing to play sports with or after an injury.
I give Elite Speed Lab and the Northshore Track Club permission to use photos and videos from the clinic to promote/advertise the club on social media and our website, etc.
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Yes
Date
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Speed and Power Training Group (Drop-in rate)-TUESDAYS @ 6:30 PM (SALMEN HIGH TRACK); Grades 4th-12th
(Nonrefundable)
$40.00
$
40.00
Speed and Power Training Group (Monthly Membership/4 sessions)- TUESDAYS @ 6:30 PM (SALMEN HIGH TRACK); Grades 4th-12th
(Nonrefundable)
$140.00
$
140.00
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