2018 Nutmeg Cross Country & Sprint Squad
Athletes Last Name *
Your answer
Athletes First Name *
Your answer
Gender *
Athletes Date of Birth *
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Indicate which program you are registering for: *
Select which group your child will be participating in at practices: *
What school does your child attend? *
Your answer
REED INTERMEDIATE STUDENTS ONLY: Will your child stay after school for practice or attend our 4:30pm practice?
Street Address *
Your answer
City/Town *
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State *
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Zip Code *
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Athletes USA Track & Field Number *
Must be a current number for this year,
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What grade is your child in? *
Athlete's Shirt Size *
Athlete's Shorts Size *
Parents Full Name *
Your answer
Parents cell phone *
For emergencies
Your answer
Parents Email *
For distribution list
Your answer
Second email
For distribution list
Your answer
Medical Concerns *
N/A if none
Your answer
List any successful modifications or concerns that will help us in coaching your child
Your answer
How did you hear about Nutmeg Striders? *
By selecting "Submit" on the registration displayed below you are acknowledging that you have read and voluntarily agree to the following Nutmeg Striders Membership Waiver: I know that conditioning exercises, running or competing in cross country and track and field events are potentially hazardous activities. I should not enter and participate in Nutmeg Striders activities unless I am medically able and properly trained. I agree to abide to any decision of a Nutmeg Striders official/coach relative to my ability to safely participate in practices and competitions. I assume all the risks associated with cross country running, road racing, conditioning, and track and field including, but not limited to: falls, contact with other participants, the effects of weather, including high heat and/or humidity, the conditions of the road and traffic on the course, the conditions of the running trails, and all such risks are known and appreciated by me. Having read this waiver and knowing these facts, and in consideration of your acceptance of my application for membership; I, for myself and anyone entitled to act on behalf, waive and release Nutmeg Striders LLC, and all sponsors and their representatives and successors from all claims or liabilities of any kind rising out of my participating in Nutmeg Striders carelessness activities, even though that liability may arise out of negligence or on the part of the persons named in this waiver. *
E-Signature (Parents sign for children under the age of 18) *
First and Last Name
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