Club Registration

Vaulter Club is committed to Six (6) days a week and we want our athletes to be committed as well! For a small monthly fee we will have club members making a difference!

Your Name (required)

Your Sex (required)

FemaleMale

Athlete Age (required)

Your Email (required)

Mailing Address, City, State, Zip Code (required)

Home Phone (required)

Parents Names (required)

Athletes Cell Phone (required)

Personal Best (required)

ALL PARTICIPANTS NEED AN ACTIVE USATF MEMBERSHIP IN ORDER TO PARTICIPATE!! (CONTACT US FOR DETAILS)

USATF Number (required)

Pick the plan that suits you best. (required)

Monthly $175.003 Month $495.006 Month $930.0012 Month $1800.00Private Lesson $30Drop-In $20 (Private lesson will have no more than two athletes at $30 per athlete)

I hereby grant permission for myself/my child to attend Vaulter Club practices and events. I verify that I/my child has had a physical exam in the past year and is capable to participate in the activities related to pole vaulting. I agree to indemnify, hold harmless and defend the Vaulter Club coaching staff, any other associated coach, our mentoring staff, Murrieta Valley Unified School District, Temecula Valley Unified School District, Chaparral High School, Mesa High School or any other pole vault practice or competition facility used by Vaulter Club, their agents, employees and sponsors from any and all liability for injury to myself or my child as well as any damage caused by myself and/or my child. I understand that track and field, and in particular pole vaulting, are potentially dangerous and could pose risk of injury during the course of instruction or competition. Sports by their very nature pose the continuous threat of injury that no type of equipment can ensure against or prevent. Should medical attention be necessary, I hereby authorize any physician or trainer selected by club personnel to conduct medical or surgical procedures.

I give my consent for emergency medical treatment of this minor in a licensed hospital by a licensed physician should his/her condition so require it in my absence. I understand that, in such a case, reasonable attempts will be made to contact me, time and conditions permitting. As long as the medical or surgical treatment is considered necessary in the situations in accordance with generally accepted standards of medical practice for the particular type of injury or illness involved, I impose no specific limitations or prohibitions regarding treatment. I will be responsible for any medical or other charges in connection with attendance of this club.

I hereby grant permission for Vaulter Club to use any photographs or videotape of club related activities for the purpose of advertising or educational materials development on our website and social media outlets.

I agree to the terms above. (required)

Athlete Signature (electronic and written required) (required)

Parent/ Guardian Signature (electronic and written required)(required)

Your Message

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Please download, fill out, and sign the consent form attached.  Have the athlete bring the form and payment (cash or check made out to Vaulter Magazine) to the first practice. Thank you

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Vaulter Club