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Charger Running Club Registration.
Elementary and Middle School Running Club
Open to grades 3-8 (2nd if accompanied by a parent)
After school every Wednesday from 3 - 4
Winter Session

When:
Wednesdays after school 3:00 pm - 4:00 PM
Cost $100.00 includes T-Shirt (you will be billed via FACTS)
First session October 30th

What you need:
-Outdoor shoes for running (not your school gym shoes)
-Proper clothing for running (please no jeans or slacks)
-Water bottle
-A positive attitude and a willingness to learn and run


How it works:
Wednesdays after school rain or shine, our cross country coach Dawn Vrentas will work with students to learn running techniques and work towards being able to run for 30-40 minutes or more non stop. Each participant will receive a running club t-shirt and there will be achievement “prizes” for distances achieved over the course of the season.
Runners First Name *
Your answer
Runners Last Name *
Your answer
Grade *
As a parent or legal Guardian, I authorize the team Physician or in his/her absence, a qualified physician, to examine the above-named student and the in the event of injury to administer emergency care and to arrange for any consultation by specialist, including a surgeon he/she deems necessary to insure proper care of any injury. Every effort will be made to contact parent or guardian to explain the nature of the problem prior to any involved treatment. *
Parents Name *
Your answer
Parents or Guardian Primary Contact Number *
Your answer
Parents or Guardian Primary Email *
Your answer
If the above parent cannot be reached in the event of an emergency please list a secondary contact Persons full name. *
Your answer
Secondary Emergency contact Phone Number *
Your answer
Primary Care Provider *
Your answer
Primary care Phone number *
Your answer
Insurance Company *
Your answer
Insurance Policy Number *
Your answer
Medications Taken by Athlete *
Your answer
Is the student allergic to any medications *
Your answer
Does the athlete have any special limitations *
Your answer
Anything you want the coaches to know about your athlete? *
Your answer
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