Arkansas |
USATF
MEMBERSHIP APPLICATION |
Mission
Statement
The mission of USATF is to provide vision and leadership to the sport of
Athletics in the United States, and to promote the pursuit of excellence from youth to
masters, from grass roots to the Olympic Games |
National
governing body for track & field, race walking, cross country running, and long
distance running.
[ ] New membership
[ ] Renewal from last year
[ ] Previous member
(last year___________) |
Last Name
First
Initial
______________________________________________
Address
______________________________________________
City
State
Zip
______________________________________________
| USATF memberships expire at the end of the
calendar year. Your membership # will be affixed in this space. |
My tax-deductible contribution to
(circle one each category): Junior Olympics or Local Association or National
Teams or Training Centers or Other _______ in the amount of $10
or $25 or $50 or $100 or $500 or Other $______ is enclosed.
By signature below, I, a
prospective member of USA Track & Field, agree to abide by the applicable USATF
Bylaws, Operating Regulations, and Rules of Competition for my level(s) and category(ies)
of membership.
_____________________________________________
SIGNATURE (If under age 18,
parent/guardian must sign) DATE |
Sex ____
Age ____ DOB___________
USA Citizen: Yes [ ] No [ ]
If No, list country:__________________
Phone # :________________________
Club # :_____ Club Name:___________
Please check the code
definitions below ...
Circle up to six member codes
here.
AY AO CH
OF AD CO PA
Please circle all applicable sports codes.
T
F R
U W
X
[ ] Check here if you do not want your address used as part of a
running-related direct mail list.
| AMOUNT ENCLOSED: |
Fees:
Extras:
Contribution:
Total: |
$_________
$_________
$_________
$_________ |
| Please
leave these boxes blank. |
|
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|
Member Category Codes
Up to six categories may be
indicated, but only one in each of the categories below (i.e. only one athlete category of
those indicated.) Additional category codes may be used by your local Association |
AY
= Athlete-Youth -or-
AO = Athlete-Open & Veterans
CH = Coach
OF = Official
AD = Administrator
CO = Contributing member
PA = Parent |
Important
information for prospective youth athlete members:
* Coach may sign with permission of
parent.
* New or lapsed membership must submit copy of birth certificate or other identification. |
|
Sport
Codes
Indicate all sport areas in which you are active:
T = Track events
F = Field events
R = Road running
U = Ultra running
W = Race walking
X = Cross country |
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Membership Fee: $20
You may register online at
www.usatf.org Renewals & new memberships, send 3 copies of application, fee & SASE to:
Tom Aspel, Membership Chairman
120 South Laredo, Russellville, AR 72801
Home Phone 501.968.4272 |
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