Parent/Athlete Information Sheet
(Please print)
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Athlete: |
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Name: |
e-mail: |
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Birth date: |
Age: |
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School: |
Grade: |
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Parent/Guardian: |
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Name(s): |
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Home Address |
e-mail: |
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City: |
State: |
Zip: |
Cell phone: □ Only contact this cell in an emergency |
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Home Phone: |
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Work Phone: |
□ Please don’t contact me at work |
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Work e-mail: |
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Spikes Use Only: |
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Age Group: Bantam Midget Youth Intermediate Young Men/Women |
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Club Dues: □ Track
$60 □
X-country $60 □ Both $100 |
□ Birth
Certificate on file |
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□ USATF Card $15 |
USATF # |
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□ AAU Card $15 |
AAU # |
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□ Uniform $45 |
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□ Misc. Spike Wear $______________ |
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□ Total paid $ ( Check #
) |
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