LIVE 2021 Middle school Registration Form
Email address *
Spot Guaranteed Due to Payment Held from last Summer *
Camper Info
Camper's First Name *
Camper's Last Name *
Camper's E-mail *
Gender *
Street *
City *
State *
Zip Code *
Parent/Guardian Name *
Parent/Guardian E-mail *
Home Phone # *
Parent Cell Phone # *
Parent Work Phone # *
Emergency Contact Name *
Emergency Contact Phone # *
School Info
Coach Name
Coach E-mail
Grade Entering *
School *
Training Info
Estimated Average Summer Running *
Please estimate the number of miles or amount of time you spend running each week during the summer.
Running Bio *
Below please describe your experience with running. Please include (if applicable) personal bests, number of years run, and anythings else you believe is pertinent.
Roommate Request (We will do our best to accommodate your request)
How did you learn about us? *
A copy of your responses will be emailed to the address you provided.
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