BMS_CC_2020_registration_form
I'm still working on how to manage cross country this season, but I am hoping it will be possible. We'll have to change some of our usual routines and likely will need more parent help at practices. Please complete this form if you have a runner or runner-to-be who might be interested. -- Chris Welsh (cwelsh@utk.edu)
Athlete info:
Athlete's name? *
Gender (male/female) *
Required
Date of birth:
MM
/
DD
/
YYYY
Age?
Grade? *
Running history?
brief info to help coaches know what your runner has done athletically in the past
What high school are you zoned for?
Parental contact info:
Mother's name:
Father's name:
Home street address: *
Primary e-mail address *
Enter preferred e-mail contact here
Alternate e-mail address
Enter additional e-mail address(es) if you want team communications sent to more than just the primary e-mail
Preferred phone number *
Provide primary phone number coach should call to reach you
Alternate phone numbers
provide additional phone numbers, note whether home, work, or cell
Emergency contact (other than parent):
Name? *
Relationship?
Phone number *
Family physician?
Physician phone #:
Medical History:
Medical history: date of last tetanus shot?
best guess is okay
Date of last physical exam?
Allergies? *
Are there any allergies coaches should be aware of?
Any current medications coaches should be aware of? *
If your runner has asthma, does he/she have an inhaler? What type?
List any medical conditions that may limit or modify participation: *
Questions? Contact Chris Welsh at cwelsh@utk.edu
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