2019 DuPage Track Club Registration Form
If this is your first year with the club we will need a copy of your athletes birth certificate in order to compete. You may not be able to compete in the state, regional or national meet if you do not get your athletes birth certificate in on time.

Please fill out this form completely.
Athletes Last Name *
Athletes First Name *
What are you signing your athlete up for? *
Athletes Date of Birth *
Male/Female *
Is the athletes a male or female?
Guardian Last Name *
Guardian First Name *
Guardian Cell Number *
Guardian Work Number *
Guardian Email Address *
Athlete Email Address *
Guardian Street Address *
Guardian City *
Guardian Zip Code *
Secondary Last Name
Secondary First Name
Secondary Cell Number
Secondary Email Address
Jersey Size - All Sizes in Boys/Mens *
T-Shirt Size - All sizes in Boys/Mens *
DuPage Track Club has my permission to submit my child’s name and/or photo to the DTC website or news articles in local newspaper *
How are you making payment? *
I acknowledge that by signing an athlete up for the club I am responsible to provide a worker such as myself or another person age 18 or over for our home meet on Saturday, July 14 as well as bring a concession item. If you cannot provide a worker you will be asked to pay $40 to pay a high school athlete to take your place. *
I understand that if this is my athletes first year in the club I must submit a copy of their birth certificate at least 10 days before the state meet to be age certified to compete at the state/regional meet. *
In consideration of your accepting this application, I do hereby, for myself, my heirs, executors, administrators, waive, release and forever discharge any and all rights and claims to me against the DUPAGE TRACK CLUB, District #108 or USATF, its officers, directors, volunteers, coaches and others aiding in the program, etc. and/or assigns for any and all damages which may be sustained and suffered in connection with said association or entry and/or arising out of traveling to or participating in and returning from practices and meets. It is expressly understood by the undersigned that he/she is solely responsible for any costs arising out of any bodily injury or property damage sustained through participation in normal or unusual activities of this program. The undersigned also understands that they are required to purchase a USATF card for their participant. I HEREBY AUTHORIZE ANY REGISTERED PHYSICIAN OR LICENSED HOSPITAL TO PERFORM ANY TREATMENT THEY JUDGE NECESSARY IN AN EMERGENCY. Please print your name below. *
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