Texas Heat Summer Track Registration 
Mission Statement: To offer lifelong progress of amateur athletics track and field competition for youth of all ages, races and creed. To enhance the physical, mental, and moral development. To promote good sportsmanship, good citizenship, and safety. To utilize the skills to pursue secondary education and become resourceful citizens in their community.

Capital of Texas Heat Track Club 
4611 Acers Lane 
Austin, TX 78725
512-769-5669
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Email *
Contact number: *
Parents Names and Email *
Athlete's Name *
Athlete's Date of Birth *
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Athletes Age By End of Current Year? *
Grade level this Fall  *
Does Athlete Have Asthma?  *
Does athlete have any medical problems that running track might aggravate?   *
If yes, explain
Date of last physical exam
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Height   *
Weight  *
School:  *
Did athlete run for the school?   *
Statement of liability release

 I will not hold the Capital of Texas Heat, Inc., Leslie Riggins (Head Coach), or any of the coaching staff members of the Capital of Texas Heat, Inc., responsible for any accident or injury to my child while he/she is under their supervision during practices, competition, and/ or fundraising activities. 

I, thereby, for myself, my heirs, assigns, and executors waive and release any and all rights and claims for damages, that I, my heirs, assigns and executors may have against the Capital of Texas Heat, Inc., its coaching staff and volunteers and their respective representatives for any and all injuries which may be suffered in connection with participation within Capital of Texas Heat, Inc., during practices, competitions, and/ or fundraising activities. 
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Emergency Medical Treatment Consent

In case of illness or accident, I give permission for the emergency medical treatment of my child, if I cannot be contacted.

I understand that I am responsible for all cost associated with the medical treatment for my child. 

 *
A copy of your responses will be emailed to the address you provided.
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