YMCA Track & Field Registration Form Player’s Name: _______________________________________ Address: ______________________ City:__________________ DOB:____/____/____School: ______________Grade:______ Parent Name(s): ______________________________________ Phone: ____________ (Primary) ____________ (Other) Email: __________________________________________________ (For sending out information) T-Shirt Size: Youth: S (6-8) M (10-12) L (14-16) Adult: S M L (We will make every effort possible to give your child the jersey size requested, but this is not always possible based on ordering deadlines.) PARENT AGREEMENT 1. I hereby certify that my child is in normal health and capable of safe participation in the youth sports program. I assume all risk(s) and hazards incidental to the conduct of this program and for the transportation to and from the program. I herby authorize the YMCA to obtain medical treatment for my child in the event that parent(s) cannot be reached. 2. I support YMCA Youth Sports philosophy, which is based on fun, fair play, participation, physical fitness and health, skill development, teamwork, family involvement, and volunteer leadership. 3. I understand that teams are divided by schools and grades and that the YMCA will try to meet parent requests, but not all requests may be granted. _______________________________________________________ Signature of Parent or Guardian Date HAVE FUN RUN FAST TRACK & FIELD APPLETON YMCA Saturdays, Apr 25 - May 16 Boys & Girls Grades K-6 (for 2014-15 school year) Practices held at St. Francis Xavier Middle School Final Track Meet is May 16 at Shattuck Middle School 8:30 AM - 12:00 PM (final times may vary) Registration begins: March 1 Registration closes: April 19 Registration March 1 – April 19 YMCA Members YMCA Youth Members General Public $10 $34 $54 Our Mission: To put Christian principles into practice by promoting youth, adult and family activities that build a healthy spirit, mind and body for all. Program Information This program will give kids the opportunity to run track. All players will participate in three—four events. The elements of fun, fitness, fair play, skill development, and family involvement are emphasized. Three weeks of practice are culminated in a association track meet. The goal of the YMCA is to provide participants a great place to learn soccer while having fun! The YMCA staff also run “Team Huddles” each week to talk about the four core values of the YMCA which are Caring, Honesty, Respect and Responsibility. All participants will receive a track t-shirt! The Track & Field Season will run for four weeks on Saturdays at St. Francis Xavier Middle School from April 25-May 9. The final week will be a track meet held at Shattuck Middle School in Neenah. The Track Meet will feature the softball toss and long jump for all participants. Children will also get to select from the following races—50, 100, 200, and 400. Grade 3-6 will also have the opportunity to opt for the 800. Registration Information Register at the Appleton YMCA Member Services Desk. The completed form as well as payment are required to register. Phone, fax, and mail registrations are not allowed. Online registration is also available. Be sure to first complete the form online and then click to complete the payment section. Fox Cities YMCA Family Member: YMCA Youth Member: General Public: Grade K-2 10:30-11:45 AM Grade 3-6 9:00-10:15 AM $10 $34 $54 Race times will depend on registration numbers. Volunteer Parent Coaches Needed! Parent volunteer coaches are a big part of making our programs successful. If you would like to help coach your child’s team, please sign your name on the registration form. Practice ideas will be available for all coaches at the Coaches Meeting. Yes, I am interested in coaching Name: _____________________________________________ Best phone number to reach you: ________________________ Email Address: _______________________________________ (Most information will be communicated through email) Circle one: Head or Assistant or Either Any Coach’s Requests: ________________________________ If you have any questions, please contact: Ryan Shanklin, Sports & Recreation Coordinator at 920.954.7622 or [email protected]