Outdoor Sign-up

SEPARATE REGISTRATION MUST BE COMPLETED FOR EACH ATHLETE. Thank you!

Full Name of Athlete
Athlete's Date of Birth
Athlete's Gender Male Female
Athlete's Complete Street Address
School Athlete Attends
Athlete's Current Grade in School (numbers only)
Which track & field events would you like to participate in this indoor season?
Full Legal Name of Parent or Guardian #1
Cell Phone Number for Parent or Guardian #1
Cell Phone Carrier (company) for Above Number
Best Contact Email for Parent or Guardian #1
Full Legal Name of Parent or Guardian #2
Cell Phone Number for Parent or Guardian #2
Cell Phone Carrier (company) for above number
Best Contact Email for Parent or Guardian #2
Has this athlete been a member of Manhattan Track Club in the past? Yes No
Emergency Contact Name, Phone Number (not listed above)
Athlete's Family Physician & Phone Number
Athlete's Health Insurance Provider, Policy Number, Phone Number
MTC Liability Waiver : YES - Indicates full agreement NO - Indicates disagreement (see head coach for direction)
Not Used