Outdoor Registration – St Louis Scorpions Track Club

Scorpions Track Club Registrant - Outdoor

Athlete First Name

Athlete Last Name

Athlete Gender

Athlete Date of Birth

Email Address

Address

Address Line 1

City

State

Zip Code

Parent / Guardian First Name

Parent / Guardian Last Name

Parent / Guardian Email

Parent / Guardian Phone

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Phone/Mobile

Medical Information - Mark those you’ve had or been affected by

Asthma

Seizures

Headaches

Heat Illness

Fainting

Heart Problems

Diabetes

Other

None

Please list other medical condition

Ever Been Hospitalized?

Yes

Currently Under Medical Care or Taking Medication?

Yes

Other

Please list below

Are You Currently Injured? If so, please explain and include any treatments

Have You had any injuries/illness needing physician’s care? If yes, please explain.

Please Select Membership

Registration Fee - 1 Athlete ($325)

Registration Fee - 2 Athletes ($600)

Registration Fee - 3 Athletes ($925)

Registration Fee - 4 Athletes ($1250)

Conditioning & Training Only (No Competition) ($225)

What is your uniform Size

Athlete #2 Information

Registered athlete must be "IMMEDIATE" family member. No exceptions!

First Name

Last Name

Athlete Gender

Athlete Date of Birth

What is your uniform Size

Athlete #2 Information

Registered athlete must be "IMMEDIATE" family member. No exceptions!

First Name

Last Name

Athlete Gender

Athlete Date of Birth

What is your uniform Size

Athlete #3 Information

Registered athlete must be "IMMEDIATE" family member. No exceptions!

First Name

Last Name

Athlete Gender

Athlete Date of Birth

What is your uniform Size

Athlete #2 Information

Registered athlete must be "IMMEDIATE" family member. No exceptions!

First Name

Last Name

Athlete Gender

Athlete Date of Birth

What is your uniform Size

Athlete #3 Information

Registered athlete must be "IMMEDIATE" family member. No exceptions!

First Name

Last Name

Athlete Gender

Athlete Date of Birth

What is your uniform Size

Athlete #4 Information

Registered athlete must be "IMMEDIATE" family member. No exceptions!

First Name

Last Name

Athlete Gender

Athlete Date of Birth

What is your uniform Size

Optional Team Backpack

I want a team backpack ($65.00)

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Pay with Credit Card

STL Scorpions Track Club
Berkeley, MO 63134

314-598-5015

OUTDOOR PRACTICE LOCATION

McCluer High School
1896 S. Florissant Rd.
Florissant, MO 63031

INDOOR PRACTICE LOCATION

Hoech Middle School
3312 Ashby Rd.
St. Ann, MO 63074

TRACK LINKS

Ozark USATF
USA Track & Field
AAU-Track & Field
Athletic.net
Coach O

MAKE A DONATION

The St. Louis Scorpions is a non-profit youth organization under Section 501(c)(3) of the Internal Revenue Code located in the St Louis, Missouri area.

Outdoor Track

Join / Registration

Register for Outdoor Track Today!

Registration $325.00

Conditioning & Training Only - $225.00

Back Pack - $65.00

Fill out form below

Athlete #2 Information

Athlete #2 Information

Athlete #3 Information

Athlete #2 Information

Athlete #3 Information

Athlete #4 Information

Our Club strives to develop into a POSITIVE OUTLET for the youth of St. Louis’ inner city and surrounding counties and communities.