MTC REGISTRATION

How Will You Be Paying?*

CASHAPP ($Mariettatrackclub1)ZELLE (mariettatrackclub@gmail.com or 770-294-1376)CHECKMONEY ORDERCASH

Medical Information
Primary Care Physician:
Allergies
Current Medications
Please list any medical conditions we should be aware of to help your child enjoy the sport.*

Waiver & Release of Liability
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 has had a medical examination within the last 12 months and, in the physician’s opinion, is physically capable of completing the sports or activities for which he/she has registered for.I, the undersigned parent or legal guardian of the athlete named above, understand that participation in the Rec Track League and all related training sessions involves physical activity and carries a risk of injury. I voluntarily assume full responsibility for any risk of loss, property damage, or personal injury that may occur as a result of my child’s involvement.I hereby release, waive, and hold harmless Marietta Track Club, its coaches, staff, volunteers, and facility from any and all liability, claims, or demands arising from or connected to my child’s participation in this program.*

I have read, understood, and agree to the Waiver & Release of Liability above.
Signature*

Clear
Date*

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Date

Please submit a COPY of the athlete Birth Certificate to - mariettatrackclub@gmail.com
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MARIETTA TRACK CLUB