for proof of age for all AAU competitions.
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Capital of Texas Heat Track Club | |||||||||||||||||||||||||||
| Post Office Box 15665 | ||||||||||||||||||||||||||||
| Austin, Texas 78761-5665 | ||||||||||||||||||||||||||||
| (512) 929 7273 | ||||||||||||||||||||||||||||
| Athletic Information Form | ||||||||||||||||||||||||||||
| Mission Statement: To offer lifelong progress of amateur athletics track and field competition for youth of all ages, races and creed, to enhance the physical, mental and moral development to promote good sportsmanship, good citizenship and safety, to utilize these skills to pursue secondary education and become resourceful citizens in their community. | ||||||||||||||||||||||||||||
| Back to Registration Home Page | ||||||||||||||||||||||||||||
| Date_________________________ | ||||||||||||||||||||||||||||
| Name________________________Address________________________ | ||||||||||||||||||||||||||||
| Home Phone___________________Age_______BirthDate_____________ | ||||||||||||||||||||||||||||
| Name of Parent or Guardian______________________________________ | ||||||||||||||||||||||||||||
| Home Phone___________________Work Phone_____________________ | ||||||||||||||||||||||||||||
| Emergency Contact________________________Phone________________ | ||||||||||||||||||||||||||||
| Family Doctor________________________Phone_____________________ | ||||||||||||||||||||||||||||
| Do you have any medical problems that running track might aggravate? Y/N | ||||||||||||||||||||||||||||
| If yes, explain__________________________________________________ | ||||||||||||||||||||||||||||
| Do you have asthma? Y/N If yes, what medication is used? ________________ | ||||||||||||||||||||||||||||
| Date of last physical exam *________________________ | ||||||||||||||||||||||||||||
| Height____________Weight___________School__________________ | ||||||||||||||||||||||||||||
| Grade this Fall ________________________Did you run for your school? Y/N | ||||||||||||||||||||||||||||
| A copy of your Birth Certificatemust accompany this form. Birth certificates are used for proof of age for all AAU competitions. |
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| *If you have not had a physical within the last year, you will need to have one completed. | ||||||||||||||||||||||||||||