top of page

Cheetah Xpress Track Club

Home /
About /
Gallery /
Contact /
Donation /
More

Use tab to navigate through the menu items.

Get Involved Join Track Club

Cheetah Xpress Logo_edited.png

Cheetah Xpress Track Club

ATHLETE APPLICATION FORM

February 2024 Track and Field Meet

February 2024 Track and Field Meet Ocean Breeze

Ocean Breeze
Coach Troy Pittman: 754-779-0229
Team Practice: At least Four Times Weekly -
(Linden Park – Linden Blvd. and Vermont Street and
(I.S. 218- 370 Fountain Avenue, Brookly, NY)

(REGISTRATION FEE: $600 per season – includes uniform)

Link to Instagram Page

PLEASE PRINT CLEARLY

Have you ever run track before:

Track

Field

Both Track And Field

Parent/Guardian First and Last Name:

Relationship:

Athlete’s First and Last Name:

Preferred Nick Name:

Gender:

Male

Female

Other

Date of Birth

Age:

Mailing Address:

Home Address (if different from mailing address):

Parent/Guardian Telephone Number:

Athlete’s Telephone Number (if applicable) :

Email

Current School:

Current Grade Level:

Have you ever run track before:

Yes

No

If Yes, When, Where, How Long:

Emergency Contact Name, Telephone Number and Relationship:

Does your athlete play any other sports?

Yes

No

If yes, please list all sports, team name and location:

Reason for joining Cheetah Xpress Track Club ( please do not leave blank ):

Please list previous injuries including dates (i.e.: sprains, fractures surgeries, etc.):

Please list any current medical conditions:

Does your child suffer from Asthma?

Yes

No

Athlete’s last medical/physical date:

Physician’s Name and Telephone number

Parent/Guardian Name (please print):

Parent/Guardian Signature:

Date Signed

* Please note: A recent physical no older than one year is required upon joining the team.

Thanks for submitting!

Cheetah Xpress Logo_edited.png

Cheetah Xpress Track Club

Follow Us On:

Home /
About /
Gallery /
Contact /
Donation /

Website by ZEROMORPH

bottom of page