By submitting this form, I hereby certify the following:

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1. I am the Parent or Guardian of the above named applicant and the information is true to the best of my knowledge.

2. I also acknowledge the reserved rights of the KATY EXPRESS TRACK CLUB and understand that the KATY EXPRESS TRACK CLUB does not provide medical coverage.

3. I give permission for the above-listed child to participate in the KATY EXPRESS TRACK CLUB Track and Field/Cross Country/Indoor Track Program. I further release the coaching staff and the KATY EXPRESS TRACK CLUB from any responsibility for bodily injury my child may receive while participating in the program.

4. I understand that I am responsible for any medical fees accrued by my child as a result of medical attention.

5. I also grant permission to the KATY EXPRESS TRACK CLUB's president or his/her designee to complete all membership forms and registration materials required by the USA Track and Field Association and Amateur Athletic Union for participation in local and national meets.

Parent/Guardian Information