FOR OFFICIAL USE ONLY
Please provide a copy of your
child's Birth Certificate and a Photo
to complete this application.
I have examined the athlete's Birth Cet1ificate and
found i t to be consistent with the Date of Birth below
REGISTRAR"S NAME
Certified by:
Date
CLUB REGISTRATION FORM
ATHLETE INFORMATION:
Gender:
M or F
(Please circle)
Last Name
First Name
Birth date
School
Age ___
Grade
Events
PARENT OR GUARDIAN'S INFORMATION:
Last Name
First Name
Relationship
Home Phone
Alt. Phone
Address
City
Zip
Email
Last Name
First Name
Relationship
Home Phone
Alt. Phone
Address
City
Zip
Email
CERTIFY: I am the Parent or Guardian of the above named applicant and the information is true to the best of my knowledge. I
also acknowledge the reserved rights of Pearland Track Xpress Track Club and understand that Pearland Track Xpress Track Club
does not provide Medical Coverage.
Parents Signature:
•
Date
There is a $25.00 assessment fee for all returned checks
PEARLAND TRACK XPRESS FEES
(Official Use Only)
Registration: $
.00 Receipt #
Age Group:
Amount Paid $
Date Received
Check #
by
Balance Due:
-
-- --
Primary: 2008 & after
Youth: 2002
Sub-Bantam: 2007 Intermediate: 2000/2001
Bantam: 2006
YM/YW: 1998 & 1999
Sub-Midget: 2005
Midget: 2004
Sub-Youth: 2003
\>-"
Parent’s Permission and Hold Harmless Form
I,
, hereby give permission for my child,
to participate in the Pearland Track
Xpress Track & Field Club Program. I further release the coaching staff and Pearland Track Xpress Track &
Field Club from any responsibility for bodily injury my child may receive while participating in the program. I
understand that I am responsible for any medical fees accrued by my child as a result of medical attention. I also
grant permission to Pearland Track Xpress Track & Field Club's president, and/or his/her designee, to complete
all registration documents required by the United States Track and Field Association and the Amateur Athletic
Union for participation in local, district and national meets, if l have agreed to my child's participation and I
am unavailable to complete the required documents.
Parent/Guardian Signature
Date
INTERNET RELEASE FORM
FOR PUBLISHING ATHLETES PICTURES ON PEARLAND TRACK XPRESS WEB SITE
Pearland Track X p r e s s is proud to feature our athletes for the community to enjoy. With your permission,
we would like to publish your child's first name, last name, event participating in, and photograph on our Web
site. Please indicate your preference by checking the appropriate spaces below.
I understand that the purpose of sharing this information electronically is to inform our community of the
Outstanding Performances of our athletes.
I give my permission for the following information about my child to be displayed on Pearland Track
Xpress’ Web site.
____My child's first and last name.
My child's photograph
____My child's individual or team event.
Signature of Parent or Guardian:__________
(Please print the information below)
Child's Name:
Parent's Name:
Date __________
MEDICAL RELEASE FORM
Please Print
Applicant's Name:____________________________________________________________
(Last)
(First)
(MI)
Franchise: PEARLAND TRACK XPRESS TRACK & FIELD CLUB
State of Texas County of
Known to all men by these documents that a request has been made to PEARLAND TRACK
XPRESS TRACK & FIELD CLUB, its agents, and/or its designees (1) to provide youth activities for
youth ages 5-18 (whether one or more) of the undersigned parent or guardian is present; (2) to transport
by automobile and/or any transport vehicle, said youth to various locations; and (3) to seek and obtain
medical assistance on behalf of the youth in the event coach and staff, and/or its designees determine the
need of same. In consideration of the granting of such requests, I, the undersigned, as legal parent or
guardian of the above listed youth do hereby release and forever discharge any and all claims,
demands, liability, legal action or cause of action on account of mishap to the above listed youth which
may occur as a result of furnishing youth activities, transportation and/or seeking medical assistance on
behalf of said youth.
In case of an emergency, please try to contact my family doctor first at:
Doctor's Name
Doctor's Phone Number
If he/she is unavailable, the doctor on call at any hospital has my permission to treat my child.
In case of emergency, I can be reached at:
Home Phone Number
Work Phone Number
Parent/Guardian Signature
Date
CALLING ALL PARENTS, GRANDPARENTS & FRIENDS!!!!
PTX NEEDS YOUR HELP!
As we seek to provide our youth athletes with quality training, a dedicated staff, and a sound support team, we need
volunteers to take a proactive role to help us reach and maintain this goal. Please review the list below and signup for
at least ONE committee to become an involved parent/grandparent of the team. Simply check off the area(s) you wish
to volunteer in. A brief description of each committee is listed below. Simply circle your choices and someone will be
in contact with you.
Team Moms
Responsible for ensuring all athletes are accounted for at all times during track meets; both under the tent and in the
stands; accompanies younger athletes to the restroom; helps with snack preparation and distribution
Team Dads
Responsible for all tents being erected at the beginning of track meets and taken down at the end of track meets, ensure
all team coolers are placed in the stands and removed from the stands once the track meet is over; assists the coach
when needed. Responsible for making sure all athletes are accounted for at all times; both in and out of the stands.
Video/Photography
Responsible for videoing team events and taking digital pictures, to be uploaded to the team website and shared with our
team and supporters
Website
Responsible for assisting with the design, implementation, and updates of the team website
Sponsorship Committee
Responsible for soliciting sponsors and tax-deductible support for the team
Travel Committee
Responsible for travel arrangements and itineraries
Fundraising Committee
Responsible for planning and organizing fundraising activities for the team
c
Banquet Committee
Assists with the planning, site selection, program, and setup, etc. for the year-end banquet
Practice Coaches
Assists coaches during practices with drills, runs, stretches, etc. to ensure athletes are warmed up, attentive and fully
engaged.
Trainers (Certified)
Ensures athletes have properly stretched and warmed up before each event and cooled down upon completion of their
running event. The trainer will also be responsible for the team's first aid kit.
Parents Name
Childs Name
Phone #
Date
Important Points to Remember
Please make sure that your athlete has the proper running shoes and a pair of "warm-ups".
Your child should bring their "warm-ups" to practice and to meets at ALL TIMES, no matter
how hot you think it may be. The weather may change quite suddenly and we want our athletes
to be prepared for such changes.
Please make sure that your athlete brings a drink to each practice.
WATER IS THE PREFERRED DRINK, although drinks such as PowerAde and Gatorade are
acceptable. SODAS ARE NOT ACCEPTABLE. Also, begin to encourage your athlete to drink
at least 8- 8oz glasses of water per day.
Athletes should not eat for at least two (2) hours prior to practice, although it is preferred that the athlete stop eating at least
three (3) hours prior to practice.
As we begin training, minimize the intake of sweets and fast foods. However, you should also begin to evaluate your athlete's diet
more carefully. The diet should contain approximately a twenty percent protein (i.e., meats, eggs, fish, chicken, beans, dairy
products, etc.), twenty percent fat (i.e., butter, red meats, plant and fish oils, etc.) and 60 percent carbohydrate (i.e., rice, wheat,
corn, potatoes, bread, pasta, fruit, etc.) split. Most importantly, eat a lot of different foods such as vegetables, fruits, fish, meats,
diary produce and grains. Also, grill, steam or bake foods, avoid boiling and frying.
As the track meets begin, make sure that you communicate with your child's coach; know what time your athlete is expected to
compete; what time he/she needs to arrive at the meet, etc.
Note that all times provided will be approximate times due to the "rolling schedules" at the majority of the meets. Therefore, you
must use your judgment to evaluate how long it will take to get to the meet; earlier is always better.
Athletes should bring drinks (preferably water), fruit, sandwiches (no cheese or mayonnaise), and healthy snack foods to each meet.
Milk products should be eaten at least three hours prior to the meet, otherwise they should be avoided. Athletes should not
eat nachos, hotdogs, etc. from the local concessions until they have completed all of their running events.
Placement on relay teams will depend on the l00M, 400M, and 800M, CONSISTANT running times recorded at the various track
meets.
**Please Note: The final decision will be at the head coach's
discretion.
The Coaching Staff would like to thank you for becoming a part of the PTX's family.
If you have any questions or concerns please do not hesitate to ask.
Let's have a great year as we prepare for the Junior Olympics!!
2016 REGISTRATION
The 2016 Pearland Track Xpress registration fee is $300.00 for full participation.
We are also offering a Non-Competitive Training option for $100.
The following is an itemization of the registration fee:
$100 MANDATORY Raffle fundraiser
Team uniform, T-shirt, shorts, duffle bag
AAU Membership ( TAC card)
Gulf AAU District Meet Registration
Miscellaneous team expenses (i.e. practice facility rental, insurance, etc.)
Note: Practice track meet entry fees are to be paid by the athlete/parent at each meet. AAU National
Qualifier and Junior Olympics entry fees will be paid by the club.
Sibling discounts will be given as listed below:
2nd child - $250
3rd child - $200
3 or more children, please see the PTX Treasurer.
The amount of MANDATORY Raffle Fundraiser tickets given to each athlete is as follows:
1st child will receive $100 in raffle tickets;
2nd child will receive $ 50 in raffle tickets.
Any additional children will not be required to sell raffle tickets
Two registration fee payment options are available for the 2016 season.
Option 1:
Payment in Full- due March 10th, 2016
Option 2:
1st Installment ($100 minimum) due- January 23rd, 2016 (Raffle Tickets will be issued)
2nd Installment (minimum of $100) due- February 6 th , 2016
Please note LATE (after Feb.6th) payment of the 2nd installment will result in the athlete n o t
receiving a uniform with the first order.
3rd Installment (remaining balance) due- February 20th, 2016
Uniform will be issued.
NO UNIFORM will be distributed until ALL fees are PAID IN FULL
ALL FEES ARE NON-REFUNDABLE!!!
For our team to be a success it is very important that you adhere to ALL deadlines set forth.
Welcome Letter
Pearland Track Xpress, (PTX) would like to welcome all parents and athletes
to the 2016 Track and Field season. We are excited that you've decided to
join our Family!!
PTX is an assembly of dedicated athletes who want to enhance their present
athletic skills. Our dedicated parents, coaches and staff are excited about the
opportunity to help the Pearland Community as well assist our youth athletes in
their pursuit of excellence on and off the track. We will strive to help the team
become a household name in the Houston and surrounding area as well as
nationwide. PTX will focus on the growth and development of the athlete as an
individual.
PTX is a parent run organization where we all are shareholders of the team.
PTX wants your athlete to be successful. Essentially every practice and track
meet is a deposit into our kid's future. Let's maximize our earning potential by
working together and laying a strong foundation. It is our goal to help our
athletes become leaders in their communities by not only being successful
athletes, but also by academic achievement and serving the community.
PTX will participate in both USA and AAU track and field meets throughout the
city. We will also participate in major track meets around the United States for
maximum exposure. PTX challenges you to be a part of what will become one of
the best track and field organizations in the country.
Again we welcome you to Pearland Track Xpress.
Thank you,
Pearland Track Xpress Staff
Pearland Track Xpress
Team Uniform Order
Form We are so excited about the upcoming Track and
Field season! Please complete the information below and
return:
PTX Athlete's Name:
_
Gender (circle one)
Male
Female
T-shirt Size (Circle One)
Child Small (6-8)
Child Med (10-12)
Child Large (14-16)
Adult Small
Adult Medium
Adult Large
Adult XL
Short Size (Circle One)
Child Small (6-8)
Child Med (10-12)
Child Large (14-16)
Child XL (18-20)
Adult Small
Adult Medium
Adult Large
Adult XL
Measured by Initials.:....:
_
Uniform Measurements
Women's
Shirt Size
Pant size
Men's
Shirt Size
Pant Size
Bust/Cup
Hips
Hips
Waist
Waist
_
Chest·--- - --Waist -- - ---- Ht
__ Wt
__