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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
Total $
50% of the total cost is due at the time of registration. The remaining balance is due
by June 27, 2009. Cancellations must be made one week in advance. There will also
be a 50% cancellation fee.

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