Intro
2022 Spring
About Us
Nike Order
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Home
About Us
Register
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PCRC Photo Gallery
Contact
Intro
2022 Spring
About Us
Nike Order
Contact Us
Home
About Us
Register
Donate
PCRC Photo Gallery
Contact
Athlete Registration
Step One: Fill Out Registration Form
Step Two: Get Ready to Run
Athlete's Name
*
Print Full Name as it appears on birth certificate. If you go by a name other than your first name, please write it in parenthesis.
First Name
Last Name
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Best Phone Number to Contact
*
(###)
###
####
Gender
*
Male
Female
U.S. Citizen
*
If no, please list country of citizenship in the notes section below.
Yes
No
Guardian One's Name
*
First Name
Last Name
Guardian One's Phone
*
(###)
###
####
Guardian One's E-Mail
*
Guardian Two's Name
First Name
Last Name
Guardian Two's Phone
(###)
###
####
Guardian Two's E-Mail
Emergency Contact Name
*
Emergency Contact Phone
*
(###)
###
####
Physician's Name
*
Physician's Phone
*
(###)
###
####
Athlete's Medical Information (Including Allergies)
*
Athlete's Birthday
*
Grade Level
*
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
School Name
*
Print name of school.
Other Sports and Extracurricular Activities
*
Please include information, so we can understand your runner better.
Liability Waiver
*
Additional waiver will be provided before XC season to address updates with COVID and training areas. I agree that the athlete and I will abide by the rules of the Park City Running Club. I also certify that the above named player is in good health to participate in the sports of Cross Country and/or Track & Field. I understand that the above named athlete will participate for the Park City Running Club at his or her own risk and will assume all liability in the case of injury. Furthermore, I release the Park City Running Club any representatives of the Park City Running Club, and the owners and representatives of the practice and competition venues of any risks, hazards and claims incidental to my child’s participation. I also give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve life, limb and well being of my dependent.
I Agree
Notes
Thank you!
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