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							Edmonton Royals Track & Field Club                                                             Edmonton Royals Track & Field Club

The Edmonton Royals provides an               Training Days & Times                            Registration Information
opportunity for athletes to improve their     Indoor Season: Starts Tues Oct. 4, 2012          Print clearly
performance in track and field, by offering   U of A Butterdome
experienced coaching, training and            Monday to Thursday 5 - 6:30pm                    Name (first & last)
competition for teens and young adults.       Saturday 10-11:30am                              __________________________________
                                              Training days for each athlete may vary          __________________________________
Our Coaches
                                              Outdoor Season – Starts April 2012
    Dwayne Van Straten                        Rollie Miles / Foote Field                       Phone Number _____ _______________
    Vince Lee                                 Monday to Thursday 5 - 6:30pm                    Cell Number _____ _________________
Dwayne Van Straten is a teacher with          Saturday 10-11:30am
Edmonton Public Schools. He has been          Training days for each athlete may vary          Birth Date ________ ________ _______
coaching track and field for over 25 years                                                     Address
both at the university, club and school       Registration Fees                                __________________________________
levels.                                       Cost $160/year and includes competition
Over the years he has coached a number        entry fees. Travel expenses vary                 __________________________________
of nationally ranked athletes and offered     depending on competition location.               Postal code __________________
his expertise to coach provincial and
national track teams as well as the           2012 Outdoor Competitions                        Email
University of Alberta Track athletes.                                                          __________________________________
                                              June - Provincials, St. Albert
Dwayne is also an accomplished Ironman               - Jack Brow, Kelowna                      School ____________________________
Triathlete.
                                              July - Twilight Meets, Edmonton
                                                                                               Health Care Number _________________
Certifications include                             - Western Midgets and Youth
- Bachelor of Phys-ed (UofA)                       - Alberta Summer Games                      Signature of team participant:
- Level 4 NCCP                                August - National Legions                        __________________________________
- Level 3 Sprints, Hurdles, Jumps, and        Other competitions may be added.
  Multiple events                             Athletes are also encouraged to participate      Printed name of parent/guardian
                                              in their school competitions.                    __________________________________
Vince Lee was a successful athlete in the
                                              Fundraising                                      Signature Parent/guardian
University of Alberta’s track and field
program for five years and a recipient of     The Edmonton Royals maintain a low               ________________________________
the U of A’s Eldon Foote Track and Field      athlete/coach ratio to maximize each
Scholarship.                                  athlete’s training experience.
Coaching qualifications                       The ONLY fundraising required is the             Date _____________________________
- Level 1 NCCP                                participation of each athlete/family at a
- Level 2 Sprints                             Casino held every 18 months. ALL athletes
                                              are required to fill 4 shifts – no exceptions.


                                                                                               Edmonton Royals Track & Field Club
Edmonton Royals Track & Field Club                                                               Edmonton Royals Track & Field Club
Informed Consent/Release Form                       Edmonton Royals Track & Field Club
As a condition of registration, the Participant
and Parent/Guardian;                                Come out and experience the events of
Agree to be solely responsible for any personal     track & field – from the fast paced
property loss and any injury, sustained during      excitement of sprints and hurdles to the
the course of your training.                        challenges of pentathlon!
Approve of my son/daughter’s attendance at                                                       Edmonton Royals
practice each day and certify that he/she is both
mentally and physically healthy and able to                                                                Track & Field Club
participate in the strenuous activities that may
be provided.                                        Why track & field is such a great sport!
Authorize the team coaches to act for me
                                                    Track and field is one of the few sports
according to their best judgement in any
medical emergency required. I also understand       where an individual athlete can enjoy the
that by signing this consent form I waive and       camaraderie of training on a team and the     Go the DISTANCE…
release my rights and claims for damages I may      spirit of competition – and yet compete as
have against representatives of Edmonton            an individual – working independently with      …FASTER than you ever
Royals Track Club for any and all damages           their coach toward personal achievement      imagined you could!
which may arise out of my child’s traveling to,     goals - never dependent on the another
participating in, or returning from and practice    athlete’s performance.
or competition.
Authorize coaches to assign participate to a                                                     Come out and experience the events of
group most appropriate for their age group and                                                   track & field – from the fast paced
ability, to request any participant to withdraw     Contact Us                                   excitement of sprints and hurdles to the
from the team if the participant is not acting in                                                challenges of pentathlon!
an appropriate and responsible manner, and to       Dwayne Van Straten
cancel the registration without the return of any
                                                    780-438-6974
fees.
                                                                                                 Training at UofA Butterdome &
Athlete name________________________                                                             Foote Field
Printed name of parent/guardian                                                                  Experienced coaches
__________________________________
                                                                                                 Personalized training plans
Signature Parent/guardian
                                                                                                 Low club fees
________________________________

                                                                                                 Dwayne Van Straten
Date _____________________________                                                               Head Coach
                                                                                                 780-438-6974


                                                                                                 Edmonton Royals Track & Field Club

						
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