2020 Penn Hills Eagles Preseason 8-week Strength & Conditioning Registration Form
Registration is $20/two days week (discount) OR $20/one day a week per participant. Fees are per week. Fees can be cash or check. You can pay weekly or in full at the sessions.
Email *
Child's Last Name
Child's First Name
Address
City
Zip
Father & Mother or Guardian's Name
Daytime/Work Phone *
Cell Phone *
Email address that you want to receive correspondence *
Date of Birth *
MM
/
DD
/
YYYY
Age *
Gender *
School *
Allergies *
Taking any medications *
List Medications
Name and Phone Number of Child's Physician
Person to contact if parents not available *
All information will be kept confidential if requested. Are there any special medical or disabilities that requires special attention that the staff should be aware of?
The Penn Hills Eagles organization trains athletes to Junior Olympic levels and is not a recreational program. It is important for the organization to get an idea of what experience whether it be participating on an organized team, former member of a track team, etc. Although it is not required to have any track experience, you may be asked to have a former/current coach give a recommendation that your child has the physical ability, mind set, trainability and positive attitude which is required to participate and perform within the parameters of the program. Please confirm acknowledgment.
Insurance coverage for child *
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, Penn Hills School District, Penn Hills Municipality or their officers, agents, representatives or successors. *
Parent Electronic Signature *
Date Signed *
MM
/
DD
/
YYYY
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy