Winter Track Tune Up Camp
Please print form with original signature to turn the first day of camp
Email address *
A Chance to Run, Inc. Registration Form
Please submit your online responses below
Please Check Camp Session *
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Participant First Name *
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Participant Last Name *
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Nick Name
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Age *
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Current Grade *
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Participant's Mailing Address:
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Parent/Guardian Name: *
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Parent/Guardian Phone Number: *
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Alternative Contact (for emergency if you cannot be contacted): *
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Alternative Contact Relationship: *
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Alternative Contact Phone Number: *
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Have you ever participated in a running sport before? *
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Please describe any medical issues, allergies or special requirements: *
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I give my permission for the above participant to take part in A Chance to Run, Inc. Winter Tune Up Track Camp. This participant, to the best of my knowledge is in good physical condition and has no know conditions that may cause a health risk to themselves or another participant. I understand that Track, running and other outdoor activities have an inherent risk factor, and that all appropriate precautions will be taken for the participant. I give permission for A Chance to Run, Inc. and it's volunteers and/or hospital staff to administer proper medical assistance to the above named participant. I agree to release and hold harmless A Chance to Run, it's volunteers and benefactors from liability for all claims, resulting in any way from my participation in this Track Camp. I understand there is no affiliation with Sarasota County School System. *
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Parent Guardian Signature: *
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A copy of your responses will be emailed to the address you provided.
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