ORGANIZATIONAL/CLUB
MEMBERSHIP APPLICATION
ORGANIZATION INFORMATION
FOR ASSOCIATION USE ONLY
Date Rec’d ___________________________
Check#___________Amt $ ______________
# of Membership Years ________________
Membership Year(s) ___________________
Assoc. # ____________ Club _____________
*Organization Name _______________________________________________
Use of "Olympics", "Team USA", or "USATF" are not permitted without permission from the USOC and/or USATF
Principal Location of the Organization
*City _______________________________ *ST ________ Zip _______________
HY-TEK Short Abbrev____________________
Approved By __________________________
Date Approved _______________________
CHECK ONE:
New Membership
Renewal from Last Year
Renewal but not from Last Year
Update Multi-year Membership
*Website Address __________________________________________________
*Age Demographics
Type of Organization
Competitive Club
Event Organizer
Corporate
Other
Sports
Youth
Masters
Open
Track
Field
Road
XC
Mountain
Ultra
Check all that apply
Trail
CONTACT INFORMATION
*
$100 late fee;
Renewal applications
received after May 1st
COMPETITIVE CLUBS
ONLY
Race Walking
*Specified contact information will be posted on
USATF website, www.usatf.org
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
Return this application form to:
Date
PLEASE REGISTER OUR
CLUB/ORGANIZATION FOR:
1 YEAR
3 YEARS
2 YEARS
4 YEARS
Fee = number of years X annual membership fee
*$100 late fee; Renewal applications received after May 1st
COMPETITIVE CLUBS ONLY
NOTE: To maintain current contact information and to properly activate the liability insurance, clubs/organizations who
apply for multi-year memberships must file a membership
application, applicable coach’s registration forms, and club
practice schedule each year.
FOR NATIONAL OFFICE USE ONLY
Date Rec’d _________________________________________
Date Ent’d __________________________________________
Entered By ______________ CC $ _____________________
Check __________________ Amt. $____________________