Running Club - Fall 2019
Email address *
Runner's First Name *
Runner's Last Name *
Homeroom Teacher *
Parent Email for Information *
Emergency Contact Name and Phone Number *
Does your child have any medical conditions that could affect them in Running Club? (Type yes or no. If yes, please explain.) *
How will your child get home on Fridays at 4:00 when Running Club is dismissed? *
Would you like to volunteer to help with Running Club? *
Please read the following: I give my permission for my child to participate in Running Club. *
Please read the following: I agree to make sure my child has a safe way home from Running Club each Friday. If my child is late being picked up 3 times, my child will be dismissed from Running Club. *
Name of Person filling out this form. *
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