NTX NICA Cycling Registration Form

Athlete Name *

First

Last

Athlete School *

Athlete Grade *

Please enter the athlete's current grade

Athlete Gender *

Athlete Jersey Size *

Athlete Phone Number *

Athlete Email *

Athlete Address *

Address Line 1

Address Line 2

City

State

Zip Code

Guardian Name *

First

Last

Guardian Phone Number *

Guardian Email *

Guardian Preferred Volunteer Position *

All student athletes are required to have a minimum of three volunteer hours completed on their behalf. If your student has extenuating circumstances, please visit with the coach.

Guardian #2 Name

First

Last

Guardian #2 Phone Number

Guardian #2 Email

Guardian #2 Preferred Volunteer Position

All student athletes are required to have a minimum of three volunteer hours completed on their behalf. If your student has extenuating circumstances, please visit with the coach.

List any medical conditions that your child has. *

This information will be used by the head coaches to monitor any health conditions that could impact your child on the trail or be relevant to first responders in the event first aid is needed.

List any prescription medications your child is taking and if they will be carrying them at team events. *

Student athletes will be responsible for carrying their medications and understanding how to administer them. Athletes cannot carry medications that are not listed by the parent.

Please list any allergies that you child has. *

Team Expectations and Release of Liability *

I have read the rider information packet and understand the expectations.
I agree to adhere to the rider expectations
I have read and agree to the terms of the liability waiver

Must check all three to complete registration

Athlete Signature *

Guardian Signature *

NTX NICA Registration Fee - You must complete your payment to finish the registration process *

Price: $ 175.00

This fee covers the NTX NICA Cycling team registration, including a team jersey. Fees for the Texas Mountain Bike League and National Interscholastic Cycling League will be paid separately in Pit Zone. Instructions will be emailed upon completing team registration.