Overton Park Elementary Running Club Signup Form
For any questions, please contact Kristin Garcia at kristin.c.garcia@gmail.com
Student Name
*
First Name
Last Name
Student Grade
*
Please Select
3rd
4th
5th
Homeroom Teacher's Name
*
Please Select
Martin
Quinn
Shelton
Streifler
Dellamura
Hearn
Hoelke
Nowell
Gonzalez
McKenzie
Patterson
Homeroom Teacher's Name
*
Please Select
Martin
Quinn
Shelton
Streifler
Dellamura
Hearn
Hoelke
Nowell
Gonzalez
McKenzie
Patterson
Participation Fee:
*
Spring for $75
Additional Contribution ($) for 5th Grade Activities
Total Payment Amount ($)
T-Shirt Size:
*
Please Select
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Parent Email
*
example@example.com
Emergency Contact
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Medical Conditions (if none, please type "none")
*
Square Payment:
Total Payment Amount ($)
*
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USD
Running Club Fee
Credit Card
Submit
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