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
INDIVIDUAL/GROUP TRAINING CAMP
1731 BROADVIEW DRIVE BILLINGS, MT 59105
406 861 4157


NAME:​ __________________________________________________________BIRTHDAY_________  


ADDRESS:____________________________________________________________  

CITY:_______________________________________STATE_____________________ZIP__________  

SCHOOL:____________________________________________________GRADE__________________  

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

__________ PAYMENT: 90 minutes ( $83.00 )

                     PAYMENT: 2 HOURS   ($98.00)


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, Sportplex 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______________________________________