Lancer Track & Field Club 2018 - 2019
Official Roster and Waiver Form to sign up for 2018-2019 Lancer Track & Field Club
Parents must complete this registration form and waiver, and turn in the check before student-athlete is able to participate.
Athlete First Name *
Your answer
Athlete Middle Initial
Your answer
Athlete Last Name *
Your answer
Gender *
Athlete Birthdate (not today's date) *
MM
/
DD
/
YYYY
Athlete Age
Your Age as of Dec 10, 2018
Your answer
Athlete Current Grade *
School Currently Attending
Street Address *
Your answer
Address 2 (Apt or Suite #)
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Home Phone (with Area Code)
Your answer
Mobile Phone (with Area Code)
Your answer
Athlete Email Address *
Can use parent's if athlete does not have their own
Your answer
Parent's Contact Information
Mother's or Father's Name or Guardian Name *
Enter first and last name of your mother/father/guardian
Your answer
Mother's/Father's/Guardian's Phone Number *
Your answer
Mother's/Father's/Guardian's Email
Your answer
Event Group
Identify the primary event group you will compete in during track season
Primary Event Group *
This is the primary event you train for during the season
Years of experience in Track & Field *
How many years of training and racing experience do you have?
T-Shirt Size *
Please choose T-Shirt size
Dates for 2018-2019 Lancer Track & Field Club

Dec 10 - Feb 7 (we will not meet the period of Dec 24-Jan 1) and schedule is subject to change

Practices are held on Monday, Tuesday and Thursday (subject to change based upon Weather or other Facility Conflicts)

Time: 3:30 - 5:30pm

We meet each day at the CHS Track Stadium

Fees for 2018-2019 Lancer Track & Field Club
Fee: $175
Fee includes:
Lancer Track & Field Club Technical Training T-Shirt
2019 USATF Membership (Non-Refundable)
8 weeks of speed, strength, and conditioning training

Please make check out to: CHS Track & Field/Cross Country Booster Club
Bring check with you to first day of Lancer Track & Field Club training

Waiver of Liability
I hereby give my permission to my child to become a member of Lancer Track and Field Club ("LTC"). I hereby give my consent for the LTC member named above to participate in on-site and off-site LTC events and programs. I give consent/permission that photographs and videos of my child may be taken and used for promotional purposes. I understand and fully accept that there are risks involved in sports, and accidents and injuries are common and are ordinary occurrences of sports. I hereby agree to accept any such risks. I Release the LTC, its directors, officers, employees, volunteers, governing board, agents, representatives, (collectively "Releases") from all liability to me for any loss or damage to property or injury to person, whether caused by Releases or by any person associated directly or indirectly with the LTC, its officers, employees or volunteers or otherwise while my child is participating in any LTC activity. In an emergency, the undersigned authorize LTC to obtain the services of such doctor, hospital, dentist or others as LTC shall determine for the benefit of the LTC member named above and the undersigned agree to pay for all medical, dental or hospital or other services required for the benefit of the LTC member named above. The undersigned shall reimburse LTC for all expenses incurred in connection with said emergency. The undersigned hereby waive any and all claims they may have against LTC relating to medical, hospital, surgical and dental care furnished to the LTC member named above pursuant to this agreement and agree to hold LTC free and harmless from all claims that the LTC member, the undersigned and others may have in relation to emergency treatment and services rendered pursuant to this agreement. This authorization shall remain in effect until revoked in writing and delivered to agent of LTC. *
Agreement to Waiver *
Required
First and Last Name of Parent/Guardian as Signature *
Your answer
Submit
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