http://www.rmflyingpantherstc.com BILLINGS TRACK CLUB sign up form -ROCKY MOUNTAIN FLYING PANTHERS TRACK CLUB
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ROCKY MOUNTAIN FLYING PANTHERS TRACK CLUB
INDOOR/ WINTER CAMP
1731 BROADVIEW DRIVE BILLINGS, MT 59105
406 861 4157


NAME:​ __________________________________________________________BIRTHDAY_________  


ADDRESS:____________________________________________________________  

CITY:_______________________________________STATE_____________________ZIP__________  


AAU #_______________________                       

SCHOOL:____________________________________________________GRADE__________________  

Make CASHIER CHECK or MONEY ORDER to R.M.F.P. / For CREDIT CARD (CC) use PAYPAL

__________ PAYMENT: FOR 1st ATHLETE $295.00( $303.00 )
                     PAYMENT: PLUS 1 or MORE $215.00 ( $223.00)
                     PAYMENT $117 x 3 Installments DEC. JAN. FEB.( For 1 Athlete)$350
                     PAYMENT $191 x 3 installments DEC. JAN. FEB. ( For 2 Athletes)$573
                     PAYMENT $215 x 3 Installments DEC. JAN. FEB. ( For 3 Athletes)$645

MEDICAL RELEASE:
I hereby authorize the coaches of the Rocky Mountain Flying Panthers Track Club, Inc to act for me according to their best judgement, in any emergency requiring medical attention. I hereby waive and release the Rocky Mountain Flying Panthers 
Track Club, Inc and the Rocky Mountain College. I know of no mental or physical problems which might affect my child's ability to safely participate in this track program. I will be responsible for any medical or other charges in connection with his or her attendance in this track program.

LIST ALL ALLERGIES and MEDICATIONS:_________________________________________________  
____________________________________________________________________________________


SIGNATURE of PARENT/GUARDIAN________________________________________________________  

PRINT NAME _________________________________________________________________________  


PHONE NUMBER _________________________EMAIL______________________________________
ATHLETE
EXTRA ATHLETE