Velocity Registration

Enrollment Form, Medical Information, and Parental Permission Form for Athletes

Submission of this form indicates that the athlete and parents(s) or guardian(s) agree to abide by the athletic policies of VELOCITY TRACK, and the AAU/USATF Organizations.

Athlete Information

First name

Last name

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Facebook Profile Name

Birthday

Name of School, Sport(s) & position

Broken Bone(s)-Date(s)

Recent Head Injury-Date(s)

Last Tetanus shot-Date(s)

Date of Last physical exam

Do you have any physical Health problems or restrictions? If yes, please explain.

Are you currently taking any medications? If yes, please explain.

Do you have any allergies? If yes, please explain and provide the name of the allergy medication you take.

I am aware that playing or practicing in any sport can be dangerous in nature involving MANY RISK ON INJURY-major or minor. Because of the dangers of participating in sports, I recognize the importance of following coach's instructions regarding playing techniques, training, and other team rules and agree to obey such instructions.

Permission & Treatment In case of injury during practice or competition, I hereby consent to have the above named athlete examined and if required to be treated by a physician or hospital. I am of the understanding that in case of injury, VELOCITY TRACK will make every effort to contact me prior to taking my child to a physician or hospital. In the event I cannot be reached, VELOCITY TRACK & its representatives have my permission to take appropriate steps to ensure the safety and well-being of my child.

Liability I, as the parent/guardian for the above-named athlete, do hereby give full permission for him/her to participate in practices and competition for VELOCITY TRACK youth team activities sponsored and conducted by the VELOCITY TRACK. As parent/guardian, I hereby release, discharge, and hold harmless VELOCITY TRACK of any and all liability connected with our child’s participation and I assume full responsibility in the event of accident/injury before, during, and after practices and competition.

Athlete's Birth Certificate

Upload PDF File

Your Signature