HAWAII MASTERS TRACK CLUB                       

                P.O.BOX 15763, HONOLULU, HI 96830-5763

 2017  MEMBERSHIP APPLICATION (MEN + WOMEN 30+)

LAST NAME:_______________________  FIRST NAME:______________ INITIAL:___

STREET ADDRESS:__________________________________________APT.______

CITY___________________________STATE_____ZIP________________-_______

TELEPHONES: HOME:________-_____  OFFICE/CELL________-_____FAX:_____-________

E-MAIL:_______________________@______________________________

DATE OF BIRTH: MONTH:___ DAY:____ YEAR:_______   2017 USATF #____________________

FAVORITE EVENTS:  (CHECK EVENTS  IN WHICH YOU PLAN TO COMPETE)

SPRINTS____,   400/800_____,   1500/3000/5000_____,    RACE WALKS_______,

HURDLES/STEEPLE_____, LONG/TRIPLE JUMPS_____, HIGH JUMP_____, POLE VAULT___, SHOT/DISCUS____,    JAVELIN____,  HAMMER/WEIGHT TOSS____, SCOTTISH GAMES____,

PENTATHLON ___,   SPRINT PENTATHLON__, DECATHLON____,   WEIGHT PENTATHLON___,

4X100 RELAY_____, 4X400 RELAY_____4x800___(HMTC HOPES TO FIELD RELAY TEAMS AT UH WOMEN’S TRACK MEETS, ALOHA STATE GAMES, USATF-HAWAII MEETS AND USATF   AND SENIOR OLYMPICS  MEETS ON THE MAINLAND.)                          

1.  I DO NOT PLAN TO COMPETE BUT I WANT TO: OFFICIATE___,     COACH____,      HELP___,         

            SPECTATE___,  SUPPORT HMTC_____, RECEIVE THE CLUB NEWSLETTERS_____

2.  I PLAN TO  BECOME A CERTIFIED USATF OFFICIAL FOR 2017-2020 YES__NO__

3.  I PLAN TO SUBSCRIBE TO  NATIONAL MASTERS NEWS: YES____NO____

  1. I WANT AN HMTC:TEE SHIRT___(one free to dues paying members)(colors: yellow and red) 

    I  PREFER THE FOLLOWING SIZE:  SMALL:__  MEDIUM:___  LARGE:__ XL:__  XXL:__

WAIVER: IN PARTICIPATING IN ANY EVENTS SPONSORED OR PARTICIPATED IN BY THE HAWAII MASTERS TRACK CLUB, I THE UNDERSIGNED, INTENDING TO BE LEGALLY BOUND HEREBY, FOR MYSELF, MY SPOUSE, CHILDREN, HEIRS, EXECUTORS AND  ADMINSTRATORS WAIVE AND RELEASE ANY AND ALL RIGHTS AND CLAIMS FOR DAMAGES I MAY HAVE AGAINST HAWAII MASTERS TRACK CLUB,  THE STATE OF HAWAII, OFFICERS AND DIRECTORS OF HAWAII MASTERS TRACK CLUB, OFFICIALS, VOLUNTEERS AND ANY SPONSORS YET TO BE NAMED FOR ANY AND ALL INJURIES SUFFERED BY ME IN THESE EVENTS. I CERTIFY THAT I AM PHYSICALLY FIT TO PARTICIPATE IN TRACK AND FIELD AND/OR DISTANCE RUNNING EVENTS. I CONSENT TO EMERGENCY TREATMENT AND HEREBY RELEASE ALL ATTENDING MEDICAL PERSONNEL FROM ANY AND ALL CLAIMS. I CONSENT TO BE SUBJECT TO RANDOM DRUG TESTS FOR BANNED SUBSTANCES. I AGREE TO ABIDE BY THE COMPETITION RULES OF USA TRACK AND FIELD AND TO BUY AN ANNUAL  USATF CARD BEFORE COMPETING IN PRACTICES AND EVENTS SPONSORED BY HAWAII MASTERS TRACK CLUB, USATF AND USATF-HAWAII.

YOUR SIGNATURE_________________________________DATE_______

MEMBERSHIP DUES: (ACTIVE MEMBERS)                                                      $25    OR: 

                    or MAILING LIST ONLY(INACTIVE, NONRESIDENTS)                                   $  5

 VOLUNTARY DONATION FOR CLUB NEEDS                                               + $             +$

WRITE CHECK PAYABLE TO: HAWAII MASTERS  TRACK CLUB)   TOTAL :$____       $____    

MAIL THIS FORM AND CHECK TO: HMTC, PO BOX 15763, HONOLULU, HI

    

  HAWAII MASTERS TRACK CLUB                      

                P.O.BOX 15763, HONOLULU, HI 96830-5763

 

 2016  MEMBERSHIP APPLICATION (MEN + WOMEN 30+)


MAIL THIS FORM AND CHECK TO: HMTC, PO BOX 15763, HONOLULU, HI 96830-5763
Go to www.hmtcgo.com for more information, schedule of track meets, etc. 

                                                                    

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