Elite205 Track & Field Club Registration

Username*

Password*

Confirm Password*

Email*

First Name

Last Name

Date of Birth

Country

Gender*

MaleFemale

Address Fields

The address information you provide will be used for verifying your identity and personalizing your experience on our platform. We ensure the confidentiality and security of your address details in compliance with our privacy policy.

Address*

Address Line 1*

Address Line 2

City*

State or Region*

Zip*

Contact Information

Your contact information will be used for account-related communications and to keep you informed about updates and important notifications. We value your privacy and will not share your contact details with third parties without your consent.

Phone Number*

Alternate Email

Preferred Contact Method*

EmailPhoneBoth

Time Zone

Athlete Demographics

First Name*

Last Name*

Date of Birth*

Current Age*

School*

Experience*

USATF Membership #*

AAU Membership #*

Have you completed Birth Verification w/ USATF and AAU*

YesNo

Medical Information/Waiver

Insurance & Policy #*

List any allergies (medication, food, etc.)*

Waiver *

I, the parent/guardian of the athlete being registered herein Hereby authorize a club representative of Elite205 Track & Field Club to seek and sign for medical treatment for my child, a member of said club, in an emergency situation. I also authorize that the same representative, be allowed to sign for medical treatment in nonemergency situations when my child is traveling with the club or when I am unable to be reached by phone. I also agree for myself, my heirs and personal representatives to waiver and release all claims for damages I may now hereafter have arising out of the above named person’s participation in any activities of Elite205 Track & Field Club. I further state that to my knowledge, applicant has no health problems or preexisting conditions, not previously mentioned that limit his/her training or activity level.

Emergency Contact

The contact information you provide will be used in the event there is an emergency and we are unable to reach you

First Name*

Last Name*

Mobile Number*

Relationship to athlete(s)*

Athlete Photographs/Images

Athlete Photographs/Images: By accepting below I understand and agree that Elite205 Track & Field Club has my permission to take and use my child’s photographs or digital images for official Club purposes.*

YesNo

ELITE205 TRACK & FIELD CLUB RELEASE OF LIABILITY AGREEMENT I/ we agree to indemnify, save and hold the ELITE205 TRACK & FIELD CLUB, 501 (c)(3) nonprofit organization It’s officers, agents, representatives, coaches and employees from and against all rights, actions ,causes, claims of liabilities, costs of expenses of any kind as well as attorney’s fees on appeal, of whatsoever kind or nature to which the organization may be subjected as a result of my participation in the activity for which I am registering. I further agree that this release shall apply in the event that (I/ my child) is disabled, injured, or incur disease of a temporary or permanent nature while participating in this activity. I/ we further agree to return any and all property issued to me upon (request), expiration of this activity Or whenever I have ceased to be a member of said activity, or in the event the equipment is lost, stolen or damaged to reimburse the ELITE205 TRACK & FIELD CLUB, 501(c)(3) nonprofit organization for said property. I/ we certify that I have fully read and understand the contents of this form and that I fully agree to all terms and conditions. This contract shall not become effective until signed by the participant, parent (in case of minor) and agent of the organization and accepted by the ELITE205 TRACK & FIELD CLUB, 501(c)(3) nonprofit organization.*

AcceptDecline

Registration Fee*