LVS CHEETAHS Track and Field

Information Form

NAME-______________________________ DOB____/_____/____________

ADDRESS STREET______________________________ Events________________

CITY______________ STATE____ Zip Code__________

Home PHONE NUMBER______________________

Athlete CELL PHONE NUMBER _______________________

Athlete Email Address__________________________________________

PARENT NAME________________________________________

Parent CELL PHONE NUMBER_________________________

Parent Email Address______________________________________

MEDICATIONS_____________________________ ALLERGIES_______________________________

Emergency contact_______________________________________

Phone Number________________________

1. I acknowledge that all sports including track and field come with personal risk.

2. I acknowledge that my son or daughter will be participating on LVS Cheetahs USA Track and Field.

Parent signature________________________________________ Date _____