HIGH JUMP CAMP REGISTRATION - Kangaroo Track Club

STEP 1

(After paying in step 1, please come back to this page to fill out the registration paperwork. without finishing both steps your child will not lock in the spot.)

STEP 2

Which location will you be attending?

Date and time of camp you will be attending:

Name of jumper

First

Last

Phone number

Address (street, city, state and zip code)

School:

Club track team:

Official competition personal best (HJ/LJ/TJ):

AGREEMENT Address Email

Are you a Kangaroo Athletics / Kangaroo TC USATF Member?

WAIVER:

Yes, I understand and give my authorization

I know of no mental or physical problems which may affect me or my child's ability to safely participate at the camp. Coaching staff is authorized to attend to any health problem or injury to me or my child while attending camp. Neither I nor my child will hold Kangaroo Track Club liable for any injuries or expenses while me or my child are at the camp. I hereby authorize my child's participation in the Kangaroo Track Club Camp (Kangaroo Athletics). I, THE PARENT/GUARDIAN of the club member authorize Kangaroo Track Club (Kangaroo Athletics / Kangaroo TC) to post in their websites information about my son/daughter that is intended to promote Kangaroo Athletics / Kangaroo TC, their camps or the athlete. Also to give my contact information to colleges and universities coaches so they can contact me.

Parent signature (or participant signature if 18+)

ATHLETE CODE OF CONDUCT

Yes, I understand and agree to comply

I will stress safety in everything I do. This includes not jumping until the coach is watching, no distracting other jumpers in the jumping area.  I will never insult, belittle, degrade, slander, nor express any negative feelings, either verbally or non-verbally, towards another club or about another club member including coaches. I will show respect to all meet officials.  I will respect the rights and beliefs of others and will treat others with courtesy and consideration.  I agree to compete fairly and by the rules.  I will respect the property of others.  I will be fully responsible for my actions and the consequences of my actions I will treat my body properly by getting proper rest, nutrition, and abstaining from use of drugs and alcohol, not abusing medicines and dietary supplements. I will make myself aware of any banned supplements and medicines.  I understand that giving attitude to the coach or person in charge is a sign of disrespect and it will be brought to my attention (the athlete) only ones by the coach or person in charge. If the problem continues I (the athlete) will be excused without refund of any kind from the camp, training session or the team.

Parent signature:

Athlete signature:

PARENT/ GUARDIAN AGREEMENT

Yes, I understand and agree to comply

I, THE PARENT/GUARDIAN of the club member, a minor, agree that I and my son/ daughter will abide by the rules of Kangaroo Athletics / Kangaroo Track Club. Recognizing the possibility of physical injury or death associated with sports and in consideration for the Kangaroo Athletics / Kangaroo Track Club accepting the registrant for its sports programs and activities, I hereby release and discharge Kangaroo Athletics LLC and Kangaroo Track Club, their board members, coaches, volunteers and associated personnel, and the owners of fields and facilities utilized, against any claim by or on behalf of the club member as a result of the club member’s participation in the programs and/or being transported to or from the same, which transportation I hereby authorize.

Date MM/DD/YEAR:

Parent/Legal Guardian Signature:

CONSENT FOR MEDICAL TREATMENT

Yes, I understand and give consent

As the parent or legal guardian of a participant in the Club (Kangaroo Athletics LLC) and its programs, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well being of my dependent.

Date MM/DD/YEAR:

Parent/Legal Guardian Signature:

Father's Name

First

Last

Mother's Name

First

Last

Parent's Primary Address (street, city, state and zip code):

Parent Mobile Phone:

Parent Work Phone:

Parent Email

Other Emergency Contact:

First

Last

Other Emergency Contact Phone #: