BMS_CC_2024_registration_form
9/23/24 - It is now too late to join the team for fall 2024.  [The BMS cross country season begins in August.  We usually start practice the first week of school in the fall.  Sign up now to receive more information when we get closer to the start of the season.  Please complete this form if you have a runner or runner-to-be who might be interested in running cross country for the Bearden MS team.  -- Coach Chris Welsh (cwelsh@retiree.utk.edu)  ]
Sign in to Google to save your progress. Learn more
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@retiree.utk.edu
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms