Poconos Registration Form 2017
Camp Dates: Monday August 14th, 2017 through Saturday August 19th, 2017

1.) Complete this Online Registration Form. A confirmation of your registration will be emailed upon completion of this form.

2.) Print out the PARENT RELEASE/AUTHORIZATION FORM and the CAMPER RELEASE FORM from our website, and complete them.

3.) Get a copy of your School Physical or Dr's Physical. (All Physicals must be dated after August 24th, 2016.) A complete immunization history MUST be included.

4.) Mail these items to the address below by August 7, 2017 or send with your deposit.


Mail the deposit or full payment to (PAYMENT IS REQUIRED TO SECURE REGISTRATION):

Cricket Batz
RUNNINGWORKS, INC.
P.O. Box 8832
Collingswood, NJ 08108

I understand that this registration for is for RunningWorks Poconos: Monday August 14th, 2017 through Saturday August 19th, 2017 (If you are looking for our Skiff Mountain Camp return to our registration page) *
Required
Camper Info
Camper's First Name *
Your answer
Camper's Last Name *
Your answer
Camper's E-mail *
Your answer
Gender *
Address
Street *
Your answer
City *
Your answer
State *
Zip Code *
Your answer
Parent/Guardian Name *
Your answer
Parent/Guardian E-mail *
Your answer
Home Phone # *
Your answer
Parent Cell Phone # *
Your answer
Parent Work Phone # *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone # *
Your answer
School Info
Coach Name
Your answer
Coach E-mail
Your answer
Grade Entering *
School *
Your answer
Training Info
Estimated Average Summer Weekly Mileage *
Personal Best 800m (Enter 00:00 if event not run) *
Hrs
:
Min
:
Sec
Personal Best 1600m (Enter 00:00 if event not run) *
Hrs
:
Min
:
Sec
Personal Best 3200m (Enter 00:00 if event not run) *
Hrs
:
Min
:
Sec
Personal Best 5k (Enter 00:00 if event not run) *
Hrs
:
Min
:
Sec
Roommate Request (We will do our best to accommodate your request)
Your answer
This will be my *
How did you learn about us? *
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