Athlete Name: _________________________
Birthdate Date: _________________________
Parent/Guardian Name: ___________________
Insurance Company Name: _______________
Address & Telephone #: __________________
Physician's Name: ______________________
Telephone #: ___________________________
(All kids 8 and under, fees will be $150)
6280 Calion Drive, Baton Rouge, LA 70812 (225) 202-8431 HEAD COACH: Rev Burnett G. King, Sr.
My child has permission to participate in all summer league track and field events during the present season. Parents should provide transportation to the track meets, unless otherwise stated by FTC. In the event that emergency medical treatment is required, I am giving my consent to FTC officials to administer and/or arrange for reasonable treatment in the absence of the parent or guardian. In the absence of the parent, an FTC official will notify the parent of the emergency as soon as possible.
Parent/Guardian Signature: ___________________________________
TOTAL FEES ARE $250 (which includes the $50 application ) fee along with uniform fee must be paid by the deadline.
MOTTO: "For We Run By Faith, Not By Sight"
FAITH TRACK CLUB REGISTRATION & WAIVER OF LIABILITY FORM
If your child/children did not participate in the previous season, we will need a copy of their birth certificate along with this form.
This form must be completed and returned with a non-refundable $50 application fee (per child) prior to your child(ren) beginning practice with the team.