• Name * Date *
• Age * Sex *MaleFemale School *
• Family Physician * Physician Phone *

Parent/Guardian Address

• Name * Home Phone *
• Other Phone 
• Address *
• Secondary Contact Name *
• Home Phone * Other Phone 

Medical History

Please list any injuries, allergies, past surgeries, or other medical information need by a camp nurse.

Camp check-out information

As you register your child for camp, we need to be aware of your plans for Friday check-out. Please fill this out:

• Approx. Time of Pick-up (between 1:00PM and 3:00 PM) *
• Will your child leave with another parent?  Who? 
• OR will you transport other campers?  Who? 

The athlete listed on this page is in good health and has my permission to participate in camp activities. The information on this sheet is accurate and I consent by typing my name in the box below.

• Parent signature * Date *

Running Background Information

• Name * Age *
• School * Coach *
• Number of years you have been running competitively *
• Best Times: 800m  Mile  2 Mile  5K 
• Other best times 

Please approximate the following:

• Present training mileage in average miles per day *
• Highest mileage week you have ever run *
• Longest run you have ever run *
• Camp group that you intend to train with most often *Lower Mileage (5-7 miles per day)Intermediate (6-10 miles)Highest (8-12 miles)

Injury History - Please list any running related injuries that you have had and when you had them. Make special note of any injuries that are current and may affect your training at camp:

Please write below any comments that people who watch you run say that you need to work on (e.g. form problems, race strategy, training errors, etc.):

Before you submit the forms, please double check that all required fields (and applicable optional ones) are filled in completely and accurately. Remember to only click "submit" once.