St. Timothy Cross Country Registration
Please complete this form for each student athlete you are registering. Have your child's details and your contact information ready. If you are registering more than one child, please submit a separate form for each student athlete.
Student Athlete Information
Student Athlete Name
*
First Name
Last Name
Grade
*
Please Select
Kindergarten
1
2
3
4
5
6
7
8
Parent / Guardian Contact Information
Parent / Guardian Full Name (Primary)
*
First Name
Last Name
Primary Parent Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email for Confirmation
*
example@example.com
Parent / Guardian Full Name (Secondary)
First Name
Last Name
Secondary Parent Email Address
example@example.com
Secondary Parent Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Apparel
Jersey Size
*
Please Select
Youth XS
Youth Small
Youth Medium
Youth Large
Youth XL
Adult Small
Adult Medium
Adult Large
Shorts Size
*
Please Select
Youth XS
Youth Small
Youth Medium
Youth Large
Youth XL
Adult Small
Adult Medium
Adult Large
Training / Road Running Comfort
How comfortable is your child with road running?
*
My child cannot complete any road running - no roads or sidewalks no matter what
My child can run on safe sidewalks / roads in a group if an adult is present
My child can run on sidewalks / roads if in a group of 3+ other students
Parent Volunteer Availability
Parent availability to be a pacing partner (not required at all practice)
Yes
No
Parent availability to help assist at practice (running not necessary)
*
Yes
No
Health Information
Medical concerns
Allergies
Waiver / Acknowledgment
Participation in school athletics involves physical activity and some risk. By submitting this form, the parent or guardian confirms that the information provided is accurate and understands that the school may contact emergency services if needed.
I acknowledge and agree to the athletic participation waiver
*
I acknowledge and agree
Date Signed
*
-
Month
-
Day
Year
Date
Parent / Guardian Typed Signature
*
Payment
Cross Country registration fee will be added before launch.
Year
My Products
*
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Cross Country registration fee
Cross Country registration fee
$125.00
$
125.00
Processing Fee
$4.04
$
4.04
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Billing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Submit
Submit
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