Registration Form for Jackrabbit Sports Corporation
Programs of interest (check all that apply)
Track Club Membership Track & Field Summer Camp
Speed & Agility Program Indoor Flag Football
Fall Sports Training Program  
Please complete the following (* denotes a required field)
Parent's Name *
Parent's Email *
Phone *
Other Phone
Street Address
Apt/Num/etc.
City
State
Zip code
Child's Name (A) *
Date of Birth *
Youth Top Size *
Youth Shorts Size *
Adult Top Size
Adult Shorts Size
Gender
Child's Name (B)
Date of Birth
Youth Top Size
Youth Shorts Size
Adult Top Size
Adult Shorts Size
Gender
 
Child's Name (C)
Date of Birth
Youth Top Size
Youth Shorts Size
Adult Top Size
Adult Shorts Size
Gender
   
Please e-mail, fax (678-261-1873) or turn in this form to a Jackrabbit representative at the event.
Jackrabbit Club, 2090A Hwy 317 #422, Suwannee, GA 30024 -MAKE CHECKS TO: JACKRABBIT SPORTS CORPORATION
Required Items
(upon visitation)		 Copy of Birth Certificate
Most Recent Report Card		 Jackrabbit Track & Field Clinic Refund Policy: All fees paid are non-refundable
Above items in RED are for Jackrabbit Club Members ONLY
 
PARENT CONSENT

I, undersigned parent and or/legal guardian of the above named son(s)/daughter(s), hereby grant permission for his/her/their participation in the activities of the Jackrabbit Track & Field Clinic and their related activities.
On behalf of my son(s)/daughter(s) and myself, I acknowledge that he/she/they will be using facilities at his/her/their own risk and I, on my own behalf, herby release, discharge and indentify the Jackrabbit Track & Field Clinic from all liability for injury to person of damage to entrant. I further understand this release applies to transportation and from all track meets and practices. You are authorized on my behalf and at my account to take measures and arrange such medical and /or hospital treatment as you may deem advisable for the well being of my son(s)/daughter(s).
Digital Signature (Typing your name in the field serves as a digital signature) Date
In case of emergency, contact Relationship to athlete Phone

Insurance Information
Your registration fee also includes automatic coverage under the AAU & USATF Group Accident Insurance Program against any accidental injury the athlete may sustain in the course of participating in and traveling directly to and from a AAU & USATF sanctioned events or the organized scheduled practice of a AAU & USATF member club.
Print this form and bring it with you to the center. Click on this link to go to the Payment page.