TEAM CSI - Medtronic TC 10 mile runner entry
Thank you for running the Medtronic TC 10 Mile on October 6, 2024 in support of Children's Surgery International (CSI). Please complete this short form to begin registration with Team CSI!
Contact us at with any questions.
Sign in to Google to save your progress. Learn more
Name *
Date of Birth (mm/dd/yyyy) *
Address Line 1 (street number and name) *
Address Line 2 (city, state and postal code) *
E-mail *
Phone *
Emergency Contact (name and relationship) *
Emergency Contact (phone number) *
Fundraising Agreement
I agree to fundraise a minimum of $750 on behalf of Children's Surgery International.  I acknowledge that any unmet balance will be my responsibility to donate.  In order to run on Team CSI, you must agree to this fundraising minimum.
Team Training Contact 
I would like CSI to share my contact information and e-mail with other CSI charity runners, in order to be included in team training opportunities and to meet others running in support of CSI.  
T-shirt size (unisex sizing)
Thank you for completing our form. We will email you shortly with step 2 of the registration process: filling out and returning CSI's 2024 Charity Race Agreement and Waiver. 
Clear form
Never submit passwords through Google Forms.
This form was created inside of Children's Surgery International. Report Abuse