MTC 2022 Outdoor Season
SEPARATE REGISTRATION MUST BE COMPLETED FOR EACH ATHLETE. Thank you!
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Full Name of Athlete *
Athlete's Date of Birth *
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Athlete's Gender *
Athlete's Complete Street Address *
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? *
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 : "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? *
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