New Form

South Austin Steel track club

2010 Registration form

Name

Gender

Male

Female

Address

city

Zip code

Date of Birth

email address

Phone number

Medical Consent And Release of Liability

I, the undersigned parent/guardian and athlete listed above, do hereby authorize the South Austin Steel Track Club coaches and /or authorized officers as Agents for the undersigned athlete to consent to Medical, Surgical or Dental Examinations, treatments, etc. In addition, I hereby release and discharge the South Austin Steel TC. Its coaches and authorized officers from any and all claims for personal injuries.  I agree that any pictures and /or results resulting from the program hours may be used for future promotional purposes, press releases, and public information.  Payment of fees and/ or participation in the program shall constitute acceptance of the conditions set forth in this release even in lieu of signatures. As the undersigned parent/ guardian and athlete, I understand that no confirmation will be mailed and no refunds can be given. Members of the South Austin Steel will be provided accident insurance for competitions and practices sanctioned by the Amateur Athletic Union (AAU)

Parent Signature

Athletes Signature

Date of last physical

Mother's name

Email address

Father's name

Email address

Emergency Contact Information

List any medical problems

Cost	$ 200 Uniform $75

Birth Certificate

Coaches Responsibility

Athletes Responsibilities

Parents Responsibilities