The South Florida Age Group Track and Field Club

Club Membership Application

Club Name:___________________________________________________

  Principal location of the Club:____________________________________

  City: ________________________ State Fl   Zip____________________

  Club Website Address: ______________________

Type of Club                      Age Demographics           Sport

Competitive club                      Youth                            Track

Corporate                                Masters                         Cross Country

Event Organizer                      Open                             Race Walking

                                   Check all that your club supports

Contact Information

  All mail and e-mail correspondence from SFAGT&F will be sent to the following

  Contact Person:_____________________________________________________________

  Club Membership# ( will be assigned) _______________________

  Shipping/Mailing Address

_____________________________________________________ 

City _______________________St _______________ Zip_______

  Phone ( Main ) (   )_________________________   Phone ( Alternate) (    )_______________

  E-Mail Address___________________________  Fax (    ) ___________________________

Officers: ( if any)_____________________________________________________________

                          President

                          ______________________________________________________________

                          Secretary

                         _______________________________________________________________

                         Coaches

Our organization, if accepted, hereby agrees to abide by the Rules and regulations of USA track and Field and to respect and enforce all decisions of South Florida Age Group Track and Field Association

For association use Only                                            Return: to SFAGT&F               Membership Dues $200 Per year

Date rec”d___                                                                7180 NW 47^th Place                   Includes. All entry fee(regardless ot number of athletes)                                                                                             

Check#___Amt__                                                           Lauderhill Fl 33319                  to April 29,2008/ certificate inc ($2,000,000) All awards1-8

Approved by____Date:____                                                                                                  places. Etc. Payment Dead line Feb 22, 2008