LG Track & Field Registration

Athlete Information

Athlete Name*

First Last

Date of Birth*

Gender*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Phone

Email*

Emergency Contact

First Last

Emergency Contact Phone

Entry Information

Team/Club Name

Age Divisions*

Youth ages are determined by birth year. So if you are born in 2010, you would be a 14 year old, even if you are 13 on the day of the meet.

1st Event - Youth Divisions*

1st Event - Open/Masters Division*

2nd Event - Youth Divisions

2nd Event - Open/Masters

3rd Event - Youth Divisions

3rd Event-Open/Masters

4th Event - Youth Divisions

4th Event-Open/Masters

Combined Events

Youth - Triathlon/Pentathlon - $25; Heptathlon/Decathlon - $35; Weight Pentathlon - $35

Total

$0.00

Your entry is not done until you have completed payment. Clicking 'submit' will lead you to a Paypal page to pay for your registration. If you leave this page before paying, you will need to enter all information again. There will be no refunds issued for non attendance.

Waiver of Liability

By checking this box and in consideration of your acceptance of my entry, I hereby for myself, my heirs, executors, administrators and assigns, waive all claims to damages which I might have against Empire State Sports Council or their Board of Directors, event officials, volunteers and site entities for any and all injuries suffered by me at said events.

Waiver Signature*

I accept

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Athlete Information

Entry Information

Waiver of Liability

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