MTC Self-Registration - 2018 Season
SEPARATE REGISTRATION MUST BE COMPLETED FOR EACH ATHLETE. Thank you!
Full Name of Athlete *
Your answer
Athlete's Date of Birth *
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Athlete's Gender *
Athlete's Complete Street Address *
Your answer
Athlete's Current Grade in School *
Your answer
Athlete Team T-Shirt Size
Full Legal Name of Parent or Guardian #1 *
Your answer
Cell Phone Number for Parent or Guardian #1 *
Your answer
Cell Phone Carrier (company) for Above Number *
Your answer
Best Contact Email for Parent or Guardian #1 *
Your answer
Full Legal Name of Parent or Guardian #2
Your answer
Cell Phone Number for Parent or Guardian #2
Your answer
Cell Phone Carrier (company) for above number
Your answer
Best Contact Email for Parent or Guardian #2
Your answer
Has this athlete been a member of Manhattan Track Club in the past? *
Emergency Contact Name, Phone Number (not listed above) *
Your answer
Athlete's Family Physician & Phone Number *
Your answer
Athlete's Health Insurance Provider, Policy Number, Phone Number *
Your answer
MTC Liability Waiver : "I hereby agree to waive the Manhattan Track Club, the coaches, and board members from any liability, claims, judgements, or demands for damages incurred while my child is practicing or competing with the Manhattan Track Club. I understand that in the event of an emergency, every effort will be made to contact me. Should I be unavailable and my child needs emergency medical / surgical treatment, I hereby give my permission to the physician selected by the coaching staff to secure proper treatment, to hospitalize, order injections, anesthesia, or surgery for my child as named on this registration form." DO YOU AGREE WITH THE ABOVE STATEMENT / WAIVER? *
We need your help! MTC will be hosting a track meet on June 16, 2018. If you are able to volunteer, you will save $75 on registration (buyout fee)!! *
Is the athlete currently an active roster member of either a High School or Middle School Track Team? *
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