CHOOSE THREE DATES YOU WILL ATTEND:

March 9 (9-11am) @ Socceroof Crown Heights

March 10 (6-8pm) @ Poly Prep HS

March 11 (6-8pm) @ Poly Prep HS

March 12 (6-8pm) @ Poly Prep HS

March 13 (6-8pm) @ Poly Prep HS

March 16 (9-11am) @ Socceroof Crown Heights

March 23 (9-11am) @ Wingate Park

March 30 (9-11am) @ Wingate Park

ATHLETE'S NAME *

First Name

Last Name

ATHLETE'S BIRTHDATE *

MM

DD

YYYY

EVENT PREFERENCE

Sprint (up to 400 meters)

Middle Distance (800 to 1600 meters)

Long Distance (1600+ meters)

Field Event (Jumps & Throws)

Hurdles

GUARDIAN/PARENT'S NAME *

First Name

Last Name

GUARDIAN/PARENT PHONE NUMBER *

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HOME ADDRESS

Address 1

Address 2

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