Athlete's First Name *Athlete's Last Name *Athlete's DOB *DD/MM/YYYYCurrent Grade *Knowing your athlete’s grade helps us place them in the right age group and ensure they train with the correct event distances and hurdle heightsCurrent SchoolKnowing the athlete’s school helps us coordinate training schedules and connect with school-based track programs when neededStreet Address *Apartment, suite, etcCity *Province *Postal Code *Country *AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre & MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweBC Athletics Number (if you have one)Parent/Guardian Name *Parent/Guardian Phone *Parent/Guardian Email Address *Emergency Contact Name *Emergency Contact Phone *Relationship to Athlete *Medical Information Form *Please check all that apply to the athlete and list any additional information belowAsthmaDiabetesEpilepsy / Seizure DisorderHeart ConditionConcussion HistoryAllergies (Please list below)Joint Issues (Knee, Ankle, Hip, Shoulder, etc.)Chronic Pain / Past FracturesADHD / ADDHearing or Vision ImpairmentMental Health Considerations (e.g., anxiety, depression)NoneOther (Please List)Medications(If relevant)Care Card Number *(In case of emergency)Additional InfoPlease list any additional medical information that could affect your athlete's participation in track activitiesThis form provides permission for a designated Coach, Coordinator, Executive Member, or Team Manager of Westshore Track Club to act on behalf of the parent/guardian in the event of a medical emergency.Medical Form Consent *Yes, I agree Parental Digital Signature *Select Your Program *Kids Program (1x/week) – $135Teens Program (2x/week) – $190Wearing a team T-shirt helps athletes feel part of the club, builds team spirit, and makes it easy to spot teammates at races. This is a technical running shirt that is included in the fees for this session. Select T-Shirt Size *Select SizeYouth Extra SmallYouth SmallYouth MediumYouth LargeYouth Extra LargeAdult Extra SmallAdult SmallAdult MediumAdult LargeAdult Extra LargeTotal Fees$Parent/Guardian Consent *By registering my child with Westshore Track Club, I hereby waive and release any and all rights and claims for damages against Westshore Track Club, its coaches, volunteers, representatives, and successors for any injuries or losses that may occur as a result of participation in club activities.Cancelation Policy *I understand that Westshore Track Club does not offer refunds for missed practices. If a practice must be cancelled due to weather or safety concerns, the club will schedule a makeup sessionAthlete Code of Conduct Athletes who committed to a previous training phase are given priority over new members when the subsequent training phase begins. Program fees are not refunded when athletes miss training, are sick or injured. Athletes are expected to refrain from the use of non-prescription drugs, alcohol and tobacco. The coaches, at their discretion, can ask an athlete to stop attending training sessions. A refund will be provided in this case. Example athlete behaviour resulting in such an action include: drug/alcohol use, unsatisfactory work ethic, attendance at training sessions, disrespectful behaviour toward coach(es) or athlete(s). I have read and agree to follow the Westshore Track Club Athlete Code of Conduct. I understand that participation is a privilege and that failure to follow the code may result in suspension or removal from the program.Date *Parental Digital Signature *Athlete Digital Signature *Registration Summary Athlete Information Name: {name-2-first-name} {name-2-last-name} Date of Birth: {date-1} Current Grade: {number-1} School: {text-8} BC Athletics Number: {text-3} Parent/Guardian Information Name: {name-1} Email: {email-1} Phone: {phone-1} Emergency Contact: {name-3} Emergency Contact Phone: {phone-2} Relationship to Athlete: {text-4} Medical Information Medical details have been provided and will be reviewed by coaching staff before the season begins. Program & Fees Program Selected: {radio-1} T-Shirt Size: {select-2} Total Owing: ${calculation-1} Consent & Code of Conduct ✔️ Parent/Guardian Consent Provided ✔️ Cancelation Policy Accepted ✔️ Athlete Code of Conduct Accepted Please review your information before submitting. You’ll receive a confirmation email with payment instructions after registration is complete. Westshore Track Club collects this information for the purpose of program registration and emergency contact only. Information will not be shared outside the club.SubmitPlease do not fill in this field.