7th Annual World AthleteIndoor Track Programs

Moorestown Athletic Center (behind Moorestown HS)

Track and Fitness Training Clinics

January 2, 916

6:30pm-8:15pm

Community Track Meets (Now there are 3 meets!)

January 23,January 30, February 6

6:15pm-9:00pm (Check-in starts at 5:30pm)

WorldAthleteIndoorTrackAcademy - for children 3-14

includes 3 training clinics and 3 track meets for only $145

Each athlete gets a Dri-FIT World Athletet-shirt.

Registration deadline:December 21, 2012. Register today!

World Athlete Indoor Track Meets - for children 3-14
Can’t do the entire track academy? Come to the track meets!

Entry fee: $12 per meet Enter as many events as you like.

40M 200M 400M 800M Mini Hurdles Relays 3lb Shot Put Jumps
Preregistration for the meets is strongly suggested

World Athletepromotesfitness and healthy lifestyles throughthe sport of track and field. All skill levels are welcome!Children are coached in sprinting, hurdling, jumping, relays, throwing events and conditioning. Thousands ofchildren have participated in World Athlete indoor and summer track. For more information, visit

Registration form on the other side of this flyer

609-304-2902

EVERYONE WINS AT WORLD ATHLETE!

The Moorestown Township Board of Education does not necessarily sponsor or endorse the contents of this notice or the organization responsible for disseminating this notice.

WORLD ATHLETE REGISTRATION Referred By:

Name______Age ___School ______

Name______Age ___School ______

Name______Age ___School ______

Address______

City______State _____Zip ______

Home Phone ______Email ____________

Parent/Guardian Name______Cell #: ______

Emergency Contact Name______Phone #: ______

RELEASE:

I certify that my child is in excellent health and may participate in strenuous activities including track and field. I agree to hold World Athlete, LLC, its coaches, staff, volunteers, World Athlete Academy, Moorestown Township Public Schools and the Township of Moorestown harmless from any and all claims of injuries sustained by my child during his/her participation in the Academy. Permission is hereby granted to World Athlete, LLC to use pictures of participants in any promotional materials. Permission is hereby granted for my child to receive medical treatment if needed. I certify that there are no limits on my child’s participation except as stated in writing and included with this release form.

Parent/Guardian Signature ______Date ______

FOR INDOOR TRACKACADEMY (includes 3 training sessions and 3 track meets):

REGISTRATION FEE:_____Athletes@ $145.00 each = $ ______

SPECTATOR FEE:_____ Spectators x $3.00 x ___ # of meets = $ ______

Under age 12 free

DONATION:WorldAthleteAcademy promotes youth track & fitness= $ ______

TOTAL PAYMENT: $ ______

FOR TRACK MEETS ONLY (for children not enrolled in the indoor track academy):

ATHLETE ENTRY FEE: _____ Athletes x $12.00 x ___ # of meets = $ ______

_____ Athletesunder 5 x $8.00 x ___# of meets = $ ______

Team Discount: $10.00 per Athlete for any team that registers 10 or more children

Please check: ___ January 23 meet ___January 30 meet ___ February 6 meet

SPECTATOR FEE:_____ Spectators x $3.00 x ___ # of meets = $ ______

Under age 12 free

DONATION:WorldAthleteAcademy promotes youth track & fitness= $ ______

TOTAL PAYMENT: $ ______

PAYMENT OPTIONS:

1) Make your check/money order payable to:3) Online registrationat
WorldAthleteTrackAcademy

Mail checks to:4) Cash accepted on-site for track meet registration

WorldAthleteTrackAcademy

4 Marcy Court

Mt.Laurel NJ 08054

2) Credit Cards Accepted: MasterCard, Visa and Discover

Card #: ______Exp. Date (MM/YYYY) ______

Signature ______Date ______
Academy Cancellation and Refund Policy can be found on worldathlete.net