Blaze Track Club Registration Form

Registration Date
Registration Date
Athlete's Name
Athlete's Name
Birth Date
Birth Date
Gender
Address
Address
Home Phone
Home Phone
Cell Phone
Cell Phone
Event Interests
Father's Name
Father's Name
Father's Cell Phone
Father's Cell Phone
Mother's Name
Mother's Name
Mother's Cell Phone
Mother's Cell Phone
I fully understand that Blaze Track Club and its coaching staff, USA Track and Field Association (USATFA), Mountain View High School and/or Orem City of the property where practice is held, will NOT BE LIABLE for any injuries to my child during these sessions. Nor will I make any attempt to file claims of liability against said organizations or individuals in the event of an injury.