XC Youth Camp Sign-Up
Register now to join the camp and improve your skills
Participant's Full Name
*
First Name
Last Name
Participant's Date of Birth
*
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Female
Male
Athlete's Teacher Name and Grade
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Email Address
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Please list any allergies, medical conditions, or special needs
By completing this form, you certify that your child has been examined by a physician and found to be in good health and able to compete in all activities without restriction. You authorize the directors of the Zimmerman Youth Cross Country & Track/ Field program to act for you according to their best judgment in an emergency requiring medical attention and release Zimmerman Youth Cross County & Track/Field and its volunteers from all claims resulting from any injury your son or daughter sustains while attending the camp.
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Payment Method
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XC Youth Camp Registration
$10.00
$
10.00
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
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Expiration Month
Expiration Year
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Expiration Year
You can also pay via venmo @ZimmermanXCTF-BoosterClub
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