Runner Sign Up

Program Registration Forms: Waiver/Release for Communicable Diseases Including COVID-19 Runner Sign Up Waiver and Release of Liability and Assumption of Risk Agreement Participant Guide Authorization for the Release of Medical Information (ARMI)

Runner Sign Up 2022-2023

"*" indicates required fields

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

Runner Ethnicity

Optional information to provide program statistics

Home Campus:*

Shirt Size (select one from each category)

Youth Size*

Men (Unisex) size*

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 that you would like to share with your coach:

Name

This field is for validation purposes and should be left unchanged.

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