Spring 2019- Running Medicine Registration
We welcome you to Running Medicine's Spring 2019 season! We look forward to spending this season with you and your family, and helping you accomplish your personal fitness goals.

Would you like to receive an awesome RM shirt and be eligible to run/walk races this season? The cost is $15, and the completion of this online form. Registration payments will be received before/after practices. We accept cash/check/debit/credit card payments. [Checks payable to NHI- Running Medicine]

Interested in donating to Running Medicine? We would lovingly receive additional tax-deductible donations.

Email address *
**Please fill out separate online registrations for each RM participant, ages 0-100! **
Last Name *
Your answer
First Name *
Your answer
Birthdate *
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Age *
Your answer
Phone Number *
Your answer
Tribe(s)/ Ethnicity *
Your answer
Prior to Spring 2019 season, how many seasons have you participated with RM? *
If this is your first season with RM, how did you find out about us? *
Your answer
Shirt Size (choose one) *
What makes you most excited to be a part of RM this spring? *
Your answer
What are your goals for this RM season? *
Your answer
We plan to look at the mind, body, and spirit benefits of RM this spring, involving data collection at the beginning, middle, and end of this spring's season. It will involve about 2-3 hours of additional time and we will give gift cards to those who participate. Would you like to be considered for participation in this study? *
Please list an emergency contact (Name/ Phone Number) for yourself *
Your answer
Please Read & Sign Waiver *
Your answer
Parent/Guardian Signature for Participants under 18 years of age
Your answer
Date *
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