Running Club

Running Club

Spring 2023
Runner 1
Name

First NameLast Name
School name
Grade
Shirt size
Insurance
Health concerns
Please any health concerns that we should know about.
Runner 2
Name

First NameLast Name
School name
Grade
Shirt size
Insurance
Health Insurance Provider and Number
Health Concerns
Any health concerns your child has that we should be aware of.
Runner 3
Name

First NameLast Name
School name
Grade
Email
example@example.com
Shirt size
Insurance
Health Insurance Provider and Member Number
Health Concerns
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
I also acknowledge the risks involved in Run Club. These include but are not limited to blisters, shin pain, soft tissue injuries, skin injuries, etc. I swear that my child(ren) are participating voluntarily, and that all risks have been made clear to me. Additionally, my child(ren) do not have any conditions that will increase my likelihood of experiencing injuries while engaging in this activity.
Signature

Run Club

Run club fee for Spring 2023

$50.00 Quantity

Enter coupon

Total

Credit Card

Cash App Pay

Runner 1