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Runner Info

Name*

First Last

Grade*

Date of Birth*

Gender*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone

Runner's Cell

Ethnicity

Optional information to provide program statistics

Campus Runner will train at:*

Runner Shirt Size (complete all)

pending availability

Youth Size*

Unisex*

Women*

Contact Information

Primary Contact Name*

First Last

Primary Contact Cell*

Primary Contact Email*

Secondary Contact Name*

First Last

Secondary Contact Cell*

Secondary Contact Email

Other Emergency Contact #1

Other Emergency Contact #2

Doctor's Name*

Doctor's Phone*

Health Insurance*

Insurance ID Number*

Allergies or known medical conditions:

Volunteers NEEDED

I am able to run/bike with the students
I am able to help at after school practice (no running/biking)
Water Station Coordinator (organizes and coordinates water station for OC Marathon)
Transportation Coordinator (works with team to arrange carpools to various events)
Apparel Coordinator (sorts orders, collects money, delivers apparel)
Food Coordinator (organizes snacks and food for various special events)

I am available to run/bike with students:

Mon
Tues
Thurs

I am available to help at after school practice:

Mon
Tues
Thurs

Name

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Runner Sign Up 2019-2020

Runner Info

Runner Shirt Size (complete all)

Contact Information

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