Organizational/club Membership Application Form
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1organizational/club
for association use only
Date Rec’d ___________________________
membership application
Check#___________Amt $ ______________
# of Membership Years ________________
organization information
Membership Year(s) ___________________
Assoc. # ____________ Club _____________
*Organization Name _______________________________________________
HY-TEK Short Abbrev____________________
Use of "Olympics", "Team USA", or "USATF" are not permitted without permission from the USOC and/or USATF
Approved By __________________________
Principal Location of the Organization
Date Approved _______________________
*City _______________________________ *ST ________ Zip _______________
check one:
r
New Membership
*Website Address __________________________________________________
r
Renewal from Last Year
r
Renewal but not from Last Year
*
Type of Organization
Sports
Age Demographics
r
Update Multi-year Membership
r Youth
r Competitive Club
r Track
r Field
*
r Masters
$100 late fee;
r Event Organizer
r Road
r XC
r Open
Renewal applications
r Corporate
r Mountain
r Ultra
received after May 1st
r Other
Check all that apply
r Trail r Race Walking
COMPETITIVE CLUBS
ONLY
*Specified contact information will be posted on
contact information
USATF website,
All mail and e-mail correspondence from USATF will be sent to the following
Contact Person ___________________________________________________________________________________
* Required to Access Club
Management Area
Current USATF Individual Membership # _________________________________________________________
Shipping/Mailing Address ________________________________________________________________________
City ______________________________________________ ST ____________________ Zip _____________________________
*Phone (Main)(
) ____________________________________ Phone (Alternate)(
) ___________________
*E-mail Address _________________________________________Fax (
) _______________________________
Officers:
President
Current USATF Membership #
Secretary
Current USATF Membership #
Other
Current USATF Membership #
Our organization, if accepted, hereby agrees to abide by the Rules and Regulations of USA Track & Field
and to respect and enforce all decisions of USA Track & Field and its Associations.
Signature of Organization Officer
Date
Return this application form to:
please register our
club/organization for:
for national office use only
r
1 YEAR
r
2 YEARS
Date Rec’d _________________________________________
r
r
3 YEARS
4 YEARS
Fee = number of years X annual membership fee
Date Ent’d __________________________________________
NOTE: To maintain current contact information and to prop-
Entered By ______________ CC $ _____________________
erly activate the liability insurance, clubs/organizations who
apply for multi-year memberships must file a membership
application, applicable coach’s registration forms, and club
Check __________________ Amt. $ ____________________
*
$100 late fee; Renewal applications received after May 1st
practice schedule each year.
COMPETITIVE CLUBS ONLY
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Parent category: Business