Enclosed is $35.00 per athlete (includes refreshments and t-shirt), payable to "PVTC" Mail to:  POTOMAC VALLEY TRACK CLUB, 611 South Ivy Street, Arlington VA 22204 or save $10 and register on-line for $25 via www.pvtc.org/youth Athlete's Name ______________________________ Grade: K   1  2  3  4  5  6  7  8  (Circle one) Parent's Name ______________________________  Date of Birth  ____/____/____ Address  __________________________________  Gender:  M  F  (Circle one) City, State, ZIP _____________________________  Parent's Phone ____________________ E-mail ____________________________________  Emergency Phone _________________ [_] My child will participate.                [_] Add me to PVTC's youth track e-mail list. [_] I will help as a volunteer coach.      [_] List my name, phone, and e-mail in the team directory I agree to waive any and all claims I or my child may have against all sponsors and all officials of these events, including USATF, Potomac Valley Track Club ,and Arlington County, Virginia, and its elected and appointed officials and employees, for any damages or injuries I or my child may suffer en route to or as a result of my participation in these meets.  I affirm that my child's physical condition and fitness are adequate to participate safely in these events.  I agree to release my child's name and photo for publicity purposes.  In case of medical emergency, I authorize my child to receive on-site first-aid or emergency medical treatment. [__] Enclosed is $_______             [__] Please contact me about financial aid [__] Enclosed is an additional donation of $_____ Parent or Guardian's Signature ____________________________________  Date ___________________