A&H Athletics

Personal Information Sheet

Runner Information:
Last Name: ______________________________________ First Name:
__________________________________________________

Male _______ Female _______ Age __________ Birth date ___________________Phone

________________________

Grade in Fall 2009 _______________ School ___________________________ Email Address:

________________________

Contact Parent:
Last Name: __________________________________First Name:
___________________________________________

Email: __________________________ Home Phone: _____________________ Mobile

Phone _________________

Address
______________________________________________________________________________
_________________

City/State/Zip
______________________________________________________________________________
__________

Emergency Contact:
Last Name: ____________________________________ First Name:
_________________________________________

Email: __________________________ Home Phone: _____________________ Mobile

Phone _________________

Address
______________________________________________________________________________
_________________

City/State/Zip
______________________________________________________Relationship:
__________________
 Registration

Runners Name: ___________________________

Years of Running Experience: _________

Check Box for Session(s) Attending:

Session 1- Endurance June 6, 2009 $50
Session 2- Nutrition June 13, 2009 $50
Session 3- Hill Running June 20, 2009 $50
Session 4- Strides/Form June 27, 2009 $50
Session 5- Weight/Strength Training July 11, 2009 $50
Session 6- Speed Work July 18, 2009 $50
Session 7- Core Training July 25, 2009 $50
Session 8- Stretch/Recovery August 1, 2009 $50
Session 9- Psychology August 15, 2009 $50
Full Summer Package All Sessions $400
Included
ADDITIONAL SERVICES
Email, homework, training logs All Summer $175
Email Service Only All Summer $75
Homework and Training Log All Summer $75
Only
“BEST DEAL” All Summer $ 550
Full Summer Package +
Email, homework, training logs
TOTAL $
Registration Fee + $15
Grand Total $
50% of the total cost is due at the time of registration.
The remaining balance is due by June 27, 2009. Only Cash
and checks are accepted. Checks may be payable to
Andrea Johnson or Heather Scott. Cancellations must be
made one week in advance. There will also be a 50%
cancellation fee.