Lancer Track Club 2017 - 2018 Sign Up Form

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Official Roster and Waiver Form to sign up for 2017-2018 Lancer Track & Field Club

Parents must complete this Registration Form and Waiver and turn in check before student athlete is able to participate.

Athlete First Name *

Athlete Middle Initial

Athlete Last Name *

Gender *

Male

Female

Athlete Birthdate (not today's date) *

YYYY

Athlete Age

Your Age as of Dec 11, 2017

Athlete Current Grade *

Other:

School Currently Attending

Carlsbad High School

Valley Middle School

Aviara Middle

Calavera Middle

Other:

Clear selection

Street Address *

Address 2 (Apt or Suite #)

City *

State *

Zip Code *

Home Phone (with Area Code)

Mobile Phone (with Area Code)

Athlete Email Address *

Can use parent's if you do not have your own

Parent's Contact Information

Please enter your parent's contact information

Mother's or Father's Name or Guardian Name *

Enter first and last name of your mother/father/guardian

Mother's/Father's/Guardian's Phone Number *

Mother's/Father's/Guardian's Email

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

Sprints (100, 200)

Middle Distance (400, 800)

Distance (1600, 3200)

Hurdles

Horizontal Jumps (Long Jump, Triple Jump)

High Jump

Pole Vault

Throws (Shot, Discus)

Other - Training for a different Sport

Years of Experience in Track & Field *

How Many Years of Training and Racing Experience do you have in Track & Field

Other:

T-Shirt Size *

Please Chose T-Shirt Size (in Adult Male sizes only)

Men's X-Small

Men's Small

Men's Medium

Men's Large

Men's X-Large

Youth Large

Youth Medium

Other:

Dates for 2017-2018 Winter Club Training

Dates for 2017-2018 Lancer Track Club Training Season are:

Dec 11 - Feb 16 (we will not meet the week of Dec 25-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 - 5 pm

We meet each day at the CHS Track Stadium or Jumps Apron

Fees for 2017-2018 Winter Club Training

Fee: $175
Fee includes:
ProCaliber Sports Technical Training T-Shirt
2018 USATF Membership (Non-Refundable)

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

I agree to waiver and acknowledge that I am signing this waiver electronically as the parent of above student

Required

First and Last Name of Parent/Guardian as Signature *

Submit

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