Speed Clinics Registration Form MEL GT Explosive Speed Clinics Narrabeen Athletics Track Name* First Last AgeAddress* Street Address City State / Province / Region ZIP / Postal Code Parents Name First Last Mobile Phone*Email* Payment Amount $65Please use child’s full name as reference for payments. Please bring: water bottle, cap, sunscreen and a light snack. Spikes optional. Wet weather: The clinic will proceed unless the track is closed. In the case of rain updates will be provided on our Facebook Page, please check the page throughout the day of your clinic. MEL GT Facebook PageParents Home Phone*ConsentParents Mobile Phone*Parents Work Phone*Please state any medical history that should be known to staffWhere did you hear about us?Little A'sAttended clinic beforeMELGT Clinic FlierMELGT WebsiteFriendYour Sports ClubName of your Sports ClubIn consideration for participating in the MEL GT Speed Clinic run by Mel GT Enterprises Pty Ltd., I agree to do so at my own risk and I accept responsibility for my safety and personal possessions. I acknowledge and understand that the Training Event may be dangerous to the extent that in some circumstances it may endanger my health or the health of others. I agree that I have chosen to participate in the MEL GT Speed Clinic. I agree to disclose any injuries, disabilities, diseases or ailments or other health concerns which may effect my safe participation or ability to safely take part in the MEL GT Speed Clinic. I agree to immediately notify Mel GT Enterprises Pty Ltd on the occurrence of any change in my health or my development of any health concerns. I also agree to abide by any decision that Mel GT Enterprises Pty Ltd may make in relation to my continued participation in the MEL GT Speed Clinic. I release, indemnify, continue to indemnify and hold harmless Mel GT Enterprises Pty Ltd, its directors, staff, or agents from all and any responsibility or liability for any losses, damages, claims, actions, costs, expenses or liabilities whatsoever suffered or incurred by me arising out of my participation in the MEL GT Speed Clinic. I ACKNOWLEDGE that I participate in the MEL GT Speed Clinic of my own free will and that I have read and understood the conditions above.Your Consent* I agree SignaturePhoneThis field is for validation purposes and should be left unchanged.