2020 Penn Hills Eagles Preseason 8-week Strength & Conditioning Registration Form
Email address *
Child's Last Name
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Child's First Name
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Address
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City
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Zip
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Father & Mother or Guardian's Name
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Daytime/Work Phone *
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Cell Phone *
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Email address that you want to receive correspondence *
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Date of Birth *
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Age *
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Gender *
School *
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Allergies *
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Taking any medications *
List Medications
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Name and Phone Number of Child's Physician
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Person to contact if parents not available *
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Any special disabilities?
Your answer
Any special needs?
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Insurance coverage for child *
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I give my child permission to participate in the Penn Hills Eagles Track Club 8-week strength and conditioning fitness program. I hereby attest that my child does not have any medical ailments that would preclude him/her from participating in any strenuous physical activities. I further understand that I am to be legally bound for my child and waive, release and forever discharge any and all rights and claims for damages which my child may have or may hereafter occur to my child against the trainers, coaches, facilitator(s), Penn Hills Eagles Track Club or their officers, agents, representatives or successors. *
Parent Electronic Signature *
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Date Signed *
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