Fall 2019- Running Medicine Registration
Welcome to Running Medicine Fall 2019 season! We look forward to spending this fall 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.

**Please fill out separate online registrations for each RM participant, ages 0-100! **
Last Name *
Your answer
First Name *
Your answer
Birth date *
MM
/
DD
/
YYYY
Age *
Your answer
Phone Number *
Your answer
Email *
Your answer
Tribe(s)/ Ethnicity *
Your answer
Shirt Size *
XS
S
M
L
XL
2XL
3XL
4XL
Size
Prior to Fall 2019 season, how many seasons have you participated with RM? (0 - 10) *
If this is your 1st season....how did you hear about us?
Your answer
What makes you most excited to be part of RM this season? *
Your answer
What is your goal(s) for this RM season? *
Your answer
Please list your emergency contact (Name/ Phone) for yourself *
Your answer
Please Read & Sign Waiver *
Your answer
Parent/ Guardian Signature for Participants under 18 years of age
Your answer
Date *
MM
/
DD
/
YYYY
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service