2010  Needham Track Club Summer Program Application
  Child #1:

First Name __ __ __ __ __ __ __ __ __ __ __ __

Last Name __ __ __ __ __ __ __ __ __ __ __ __

Age on July 1 ______  Birthdate ___________

Sex ___   Current Grade _____   Cyclone? _____

T-Shirt Size  (cicle one)

Child's: 6-8   10-12      14-16         Adult:     S    M    L   

Child #2:

First Name __ __ __ __ __ __ __ __ __ __ __ __

Last Name __ __ __ __ __ __ __ __ __ __ __ __

Age on July 1 ______  Birthdate ___________

Sex ___   Current Grade _____   Cyclone? _____

T-Shirt Size  (cicle one)

Child's: 6-8   10-12     14-16        Adult:    S    M    L   

 

Parent Names ___________________________________________   Home Phone ________________________

Home Address _______________________________________     Cell/Other  Phone _______________

Town _______________________________   Zip__________  Email _______________________ 

Injury Waiver:  I absolve the Town of Needham and the NEEDHAM TRACK CLUB and all coaches, officials, and other CLUB members from liability and will not hold them responsible for injury incurred to my children, myself or my spouse.   This includes, but is not limited to , collisions and interactions among children and adults, injuries due to contact with the facilities or equipment, or to weather conditions.   I give approval to my family's participation in the Summer Program.   All family participants are in sound medical condition for on-field activities.  I understand that medical insurance is not provided.

SIGNED ________________________________________________     DATE ________________

Each year, the Needham Track Club hosts a number of special events.   They are heavily volunteer driven.  No experience is needed   -  just a willingness to help make these events something special for the youth participants.     
 

Can you volunteer at the GREAT BEAR RUN   

Sunday May 16

YES            NO           Tell Me More

Can you volunteer at the YOUTH CLASSIC  

Friday, Saturday July 16-17

YES          NO          Tell Me More

 

Summer Season Volunteer   #1:

First Name __ __ __ __ __ __ __ __ __ __ __ __

Last Name __ __ __ __ __ __ __ __ __ __ __ __

Experience __________________

Previous NTC coach? _____________

Preferred Assignment ____________________

T-Shirt Size  (cicle one)  S      M     L      XL XXL

Summer Season Volunteer   #2:

First Name __ __ __ __ __ __ __ __ __ __ __ __

Last Name __ __ __ __ __ __ __ __ __ __ __ __

Experience ___________________

Previous NTC coach? _____________

Preferred Assignment ____________________

T-Shirt Size  (cicle one) S      M     L      XL XXL

 

INSTRUCTIONS

  1. Complete application (use additional form for additional children)
  2. Write a check to NEEDHAM TRACK CLUB ($159 per child,  family maximum of $399)
  3. Early Bird Rates (recieved by 3/1/2010): $132 per child, maximum $349
  4. IMPORTANT:   Enclose self-stamped, self-addressed business-sized envelope.
  5. Send  to     NEEDHAM TRACK CLUB       53 Coulton Park         Needham, MA  02492