HAWAII MASTERS TRACK CLUB
P.O.BOX 15763, HONOLULU, HI 96830-5763
2008 MEMBERSHIP APPLICATION (MEN + WOMEN 30+)
LAST NAME:_______________________ FIRST NAME:______________ INITIAL:___
STREET ADDRESS:__________________________________________APT.______
CITY___________________________STATE_____ZIP________________-_______
TELEPHONES: HOME:________-_____ OFFICE/CELL________-_____FAX:_____-________
E-MAIL:_______________________@______________________________
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 AM OR PLAN TO BECOME A CERTIFIED USATF OFFICIAL FOR 2004-2008 YES__NO__
3. I PLAN TO SUBSCRIBE TO NATIONAL MASTERS NEWS: YES____NO____
4. I WANT TO BUY AN HMTC:TEE SHIRT___/TANK TOP___(New colors: goldenrod and dark red)
I PREFER THE FOLLOWING SIZE: SMALL:___ MEDIUM____ LARGE____ XTRA LG__
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, USATF-HAWAII, SENIOR OLYMPICS/ STATE GAMES.
YOUR SIGNATURE_________________________________DATE_______
MEMBERSHIP DUES: (ACTIVE MEMBERS) $14 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 96830-5763
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