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USA Track & Field Membership
Application
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FOR YOUR INFORMATION
- Your USATF Membership form is included below. Print the
form and complete the information. Please print or type
all information.
- Use two numerals in each box for Date of Birth (i.e.
February 5, 1963 = 02-05-63, November 20, 1963 =
11-20-63.)
- If you are not a U.S. citizen, indicate the country of
which you are a citizen in the space provided.
- Identify the member category(ies) which apply to
you.
- Identify the sport(s) in which you participate.
MEMBERSHIP FEES
Fees for USA Track & Field membership
are a maximum of $15 except for the contributing member
category which starts at $20 and may offer additional
benefits the more you contribute. Some local Associations
will offer membership at reduced rates to youth and other
categories - check with your local association for more
information. Benefits include the periodic magazine "The
Record," accident insurance, and such local benefits as the
Association may provide.
Please use these codes to indicate your membership
category(ies) and sport area(s). Remember that - except for
the contributing membership - only one $15 fee is currently
required for as many categories as you wish to
indicate.
MEMBERSHIP 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.
| Code |
Description |
AY
AO |
Athlete-Youth -or-
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 ID
SPORT CODES
Indicate all sport areas in which you are
active:
| Code |
Description |
| T |
Track events |
| F |
Field events |
| R |
Road running |
| U |
Ultra running |
| W |
Race walking |
| X |
Cross Country |
USA TRACK & FIELD
P.O. Box 1905
Brookline, MA 02246-1905
(617)566-7600
|
|__| New
Membership
|__| Renwal
from last year
|__| Previous
member (last year 19_____) |
MEMBERSHIP FEES: $15.00 / 18 yrs & Under
$15.00
(USATF membership expires at the end of the
calendar year.)
| __________________________________ |
_____________ |
_____________ |
|
LAST NAME |
FIRST |
INITIAL |
|
______________________________________________________________ |
|
ADDRESS |
| ________________________ |
|__|__| |
|__|__|__|__|__| - |__|__|__|__| |
|
CITY |
STATE |
ZIP CODE |
| |__| |
|__|__| |
|__|__|__|__|__|__| |
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SEX M/F |
AGE TODAY |
DATE OF BIRTH |
| |__| |
________________________________________ |
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USA CITIZEN Y/N |
IF NO, COUNTRY OF CITIZENSHIP |
| |__|__|__| / |__|__|__| -
|__|__|__|__| |
|
PHONE NUMBER |
| |__|__|__| |
__________________________________________________ |
|
CLUB NUMBER |
CLUB NAME |
|
|__|__| |__|__| |__|__| |__|__| |__|__| |__|__| |
|
PLEASE INDICATE UP TO SIX MEMBER CODES HERE |
| T |__| F
|__| R |__| U
|__| W |__| X
|__| |
|
PLEASE CHECK ALL APPLICABLE SPORT CODES HERE |
| My tax-deductible contribution to:
|__| Junior Olympics |__| Local
Association |__| National Teams
|__| Training Centers |__| Other
__________ in the amount of |__| $10
|__| $25 |__| $50
|__| $100 |__| $500
|__| Other $__________ is enclosed. |
| Fees: |
$ __________ |
| Extras: |
$ __________ |
| Contribution: |
$ __________ |
| Total: |
$ __________ |
| By signature below I, a prospective
member of USA Track & Field, agree to abide by
applicable USATF Bylaws, Operating Regulations, and Rules
of Competition for my level(s) and category(ies) if
membership. |
|
______________________________________________ |
_____________ |
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SIGNATURE (If athlete is under age 18, parent/guardian
must sign instead of athlete.) |
DATE |
