Running Medicine Farmington Registration Form: Spring Season 2019
Welcome all to our Spring 2019 season!

** Please fill out a separate online registration for each participant, ages 0-100! **

Each person who wants to receive an awesome RM incentive and run/walk races with us must attend 15 practices in addition to completing this form. We would lovingly receive any tax-deductible donations for RM of any amount.

$15.00 Is Due at the Beginning of the Season (April 2nd)
Email address *
Your answer
First Name *
Your answer
Last Name *
Your answer
Birthdate *
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Age *
Your answer
How many times a week do you exercise? *
Tribe(s)/Ethnicity *
Your answer
Phone number *
Your answer
Can this phone receive texts? *
Size shirt: Adult shirts will be unisex
What are 1-2 fitness goals you have for 2019? *
Your answer
Emergency Contact (First & Last Name, contact information) *
Your answer
Do you have any existing medical conditions? *
Your answer
Medications currently taking (include meds taken as needed such as albuterol for asthma) *
Your answer
Running Medicine Membership Waiver of Participation
Please read and sign the waiver *
Your answer
Today's Date
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