2024 Penn Hills Eagles Track Club Registration Form - Outdoor Season-Late
Make check or money order to PHETF.  Mail Registration fee to PHETC, PO Box 17606, Pgh PA  15235.  You can also make your payment through Zelle at pheaglestrack@aol.com.  Please make sure that you type athlete(s) name and what program registering for in the notes.   Registration fee must be received by Mar. 18 to guarantee your uniform is ordered on Mar. 19.

ATTENTION:   WE ARE NO LONGER TAKING APPLICATIONS FOR THE 6-10 YEAR OLD AGE GROUP.  WE HAVE MET OUR MAXIMUM CAPACITY AND THE 6-10 YEAR OLD AGE GROUP IS CLOSED.  You can contact us at pheaglestrack@aol.com to be placed on the waiting list.  If your child is 10 and will be 11 by Dec. 31 of this year, they will compete in the 11-12 yr old age group.  We are still accepting applications for 11 yrs and older ONLY.

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Email *
Child's Last Name
Child's First Name
Address
City
Zip
Father & Mother or Guardian's Name
Daytime/Work Phone *
Cell Phone *
Email address that you want to receive correspondence *
Date of Birth *
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Age *
Gender *
School *
Allergies *
Taking any medications *
List Medications
Name and Phone Number of Child's Physician
Person to contact if parents not available *
All information will be kept confidential if requested.  Are there any special medical or disabilities that requires special attention?
Insurance coverage for child *
I give my child permission to participate in track and field/cross country/indoor events for the Penn Hills Eagles Track Club.  I hereby attest that my child does not have any medical ailments that would preclude him/her from participating in any strenuous physical activities.  I further understand that I am to be legally bound for my child and waive, release and forever discharge any and all rights and claims for damages which my child may have or may hereafter occur to my child against USATF, TRAC, Penn Hills Eagles Track Club or their officers, agents, representatives or successors, Penn Hills Senior High School, Linton Middle School, Penn Hills Township, Penn Hills School District, board of directors and officials. *
Parent Electronic Signature *
Date Signed *
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