Running Medicine Registration Form: Spring 2017
This season is FREE and will be funded on the loving community we have worked to create in the last 15 months!
* You can earn a sweet RM water bottle by registering and attending 10+ practices.
* If you want to buy an RM shirt, we will have those available in multiple colors/styles for $15 each


First and Last Name *
Your answer
Age *
Your answer
What group will you be participating with? *
Tribe(s) / Ethnicity *
Your answer
Phone *
Your answer
Is this a cell phone that can receive texts? *
Email *
Your answer
How many seasons have you run/walked with RM? *
What 1-2 goals do you have for your summer season with RM? *
Your answer
Primary Contact Info (First and last name, relationship to athlete, phone number, and email) *
Your answer
Secondary Contact Info (First and last name, relationship to athlete, phone number, and email) *
Your answer
Do you have any medical conditions? If YES, please tell us the medications you currently take. *
Your answer
Please read and sign the waiver
Please read and sign the waiver
Today's date *
MM
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DD
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YYYY
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