Camp/Clinic Registration Form
  1. First Name:
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  2. Last Name:
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  3. Phone Number:
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  4. Email Address:
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  5. Emergency Phone Number
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  6. Street:
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  7. City, State, Zip
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  8. Athletic History: How long have you been racing? Distances? PRs?
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  9. Additional Information: Anything else we should know? (Medical concerns, injuries, allergies etc)
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  10. What are your race goals for 2010/2011?
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  11. Session:




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  12. ACKNOWLEDGMENT, WAIVER AND RELEASE FROM LIABILITY (AWRL)

    I HEREBY AFFIRM THAT I AM EIGHTEEN (18) YEARS OF AGE OR OLDER, I HAVE READ THIS WAIVER, AND I UNDERSTAND ITS CONTENTS.

    Initials(*)
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  13. Enter these 4 digits:
    Enter these 4 digits:
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  14. Submit
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