Athlete Registration

Monthly Registration Form

Fill out the form carefully for registration
Athlete's Name*

First NameLast Name
Age
Gender*
Male or Female
Date of Birth*

MonthDayYear
Date
Phone Number
Please enter a valid phone number.
Email Address
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School*
Grade Level*
2nd Grade
Athlete's Running Experience*

Beginner: Less than 2 yearsIntermediate: 2-3 yearsExperienced: 3 years+
Parent/Guardian Information
Name*

First NameLast Name
Parent/Guardian E-mail*
example@example.com
Parent/Guardian Mobile Number*
Relationship*
Secondary Parent/Guardian Information
Parent/Guardian E-mail (2)
example@example.com
Parent/Guardian Mobile Number (2)
Please enter a valid phone number
Relationship
PERSON OTHER THAN PARENT OR LEGAL GUARDIAN TO NOTIFY IN CASE OF EMERGENCY
Emergency Contact*
First and Last Name
Relationship to Athlete*
Phone Number*
Please enter a valid phone number.
As the parent or legal guardian of the above athlete, I authorize a Pure Talent Track Club representative to seek and sign for medical treatment for my child in the case of an emergency situation. I also authorize the same representative to be allowed to sign for medical treatment in non-emergency situations when my child is traveling or when I am unable to be reached by telephone. I fully understand that participation in athletics, in this case track and field, could result in both minor and serious injury and even death. I further understand that to minimize the risk of injury or harm, the athlete should have had a physical within the past year. I assume any and all risks associated with the above athlete's participation as a member of Pure Talent Track Club and I hereby waive and release Pure Talent Track Club, its coaches, representatives and, the City of Wesley Chapel of any and all rights for damages or injuries suffered while participating with Pure Talent Track Club during a scheduled practice, conditioning session or competition; while traveling to or from a scheduled practice, conditioning session or competition; or during any other Pure Talent Track Club related activity.
Parent/Guardian Signature*

Powered by Jotform SignClear
Date*

MonthDayYear
Date
By signing below, I, a prospective member and parent/guardain of AAU Track & Field and USATF, agree to abide by the applicable AAU and USATF Bylaws, Operating Regulations and Competition Rules for my Level(s) and Category(s) of Membership. If in violation, I understand this may result in removal from the team and revocation of my membership.
Athlete's Signature*

Powered by Jotform SignClear
Date*

MonthDayYear
Date
Parent/Guardian Signature*

Powered by Jotform SignClear
Date*

MonthDayYear
Date
Clothing Size(s): (Uniform, Shorts/Pants, Shirt/Jacket, etc.)*
My Products*
Categories:All

All
prevnext( X )
Team Registration2026 Monthly Registration
$370.00 Quantity
Item subtotal:$0.00

Subtotal

$0.00

Tax

$0.00

Total

$0.00
Payment Methods

Fastlane Checkout

Choose from one of the PayPal options to make your payment.

Contact Info

Payment Info
Should be Empty:

Monthly Registration Form

Parent/Guardian Information

Secondary Parent/Guardian Information

PERSON OTHER THAN PARENT OR LEGAL GUARDIAN TO NOTIFY IN CASE OF EMERGENCY