Scottsbluff Track Club
Registration form for the 2021 Scottsbluff Track Club.
Practice time and dates: 5:30-6:30pm, April: 7,13,15,20,22,26,29. May: 4,6,11,13,18,25,27
Athlete's First and Last Name
Date of Birth
Bluffs Middle School
Cell Phone #1: First Emergency Contact Name and Number
Cell Phone #2: Second Emergency Contact Name and Number
Parent/Guardian First and Last Names
Team T-Shirt Size
Is there one thing about your child that would help us coach them well?
Are you interested in being a Track Club Volunteer
Helping out at practice(assisting other adults with a group of athletes, not by yourself)
Helping at our track meet on Saturday May 29
Participation Release: By typing my name below the athlete listed on this form has permission to participate with the Scottsbluff Youth Track Club in practices, meets or other club functions. I hereby accept full responsibility for this participation and shall hold harmless the Scottsbluff Youth Track Club and their representatives for any and all damages that may result from his or her participation. In case of injury or illness, I hereby request that (if unable to reach a parent) the staff contact the above noted person. If unable to reach that person, the club is authorized to take the athlete to a hospital or other medical treatment center, and I hereby authorize treatment. (Please enter your name and date.)
Track Club Registration Fee: $50
Cash: Bring your payment in an envelope with your name on it to practice on April 6th
Check: Make your check payable to Scottsbluff Track Club. Bring your payment in an envelope with your name on it to practice on April 7th
Pay online at Paypal.com: Send payment to:
Questions or Comments
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Scottsbluff Public Schools.