MTC 2019 / 2020 Indoor Season
SEPARATE REGISTRATION MUST BE COMPLETED FOR EACH ATHLETE. Thank you!
Full Name of Athlete *
Your answer
Athlete's Date of Birth *
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/
DD
/
YYYY
Athlete's Gender *
Athlete's Complete Street Address *
Your answer
Athlete's Current Grade in School (numbers only) *
Your answer
Athlete Team T-Shirt Size
Which track & field events would you like to participate in this indoor season? *
Your answer
Full Legal Name of Parent or Guardian #1 *
Your answer
Cell Phone Number for Parent or Guardian #1 *
Your answer
Cell Phone Carrier (company) for Above Number *
Your answer
Best Contact Email for Parent or Guardian #1 *
Your answer
Full Legal Name of Parent or Guardian #2
Your answer
Cell Phone Number for Parent or Guardian #2
Your answer
Cell Phone Carrier (company) for above number
Your answer
Best Contact Email for Parent or Guardian #2
Your answer
Has this athlete been a member of Manhattan Track Club in the past? *
Emergency Contact Name, Phone Number (not listed above) *
Your answer
Athlete's Family Physician & Phone Number *
Your answer
Athlete's Health Insurance Provider, Policy Number, Phone Number *
Your answer
MTC Liability Waiver : "I hereby agree to waive the Manhattan Track Club, the coaches, and board members from any liability, claims, judgements, or demands for damages incurred while my child is practicing or competing with the Manhattan Track Club. I understand that in the event of an emergency, every effort will be made to contact me. Should I be unavailable and my child needs emergency medical / surgical treatment, I hereby give my permission to the physician selected by the coaching staff to secure proper treatment, to hospitalize, order injections, anesthesia, or surgery for my child as named on this registration form." DO YOU AGREE WITH THE ABOVE STATEMENT / WAIVER? *
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