Youth Running Club June 3-July 31

$110.00

Name of Participant*
First Middle Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Participant Date of Birth*
Month
Day
Year
Grade entering in 2025*
Gender*
- Male
- Female
Would you like to add a t-shirt for $15?
Customized Ultimook Running Club T-shirt, optional.
- Yes
- No
T-shirt
Price:
T-shirt size
Is there anything we should share about your child with our coaches?
We take lots of photos of kids participating in practice. We may post these pictures on our Facebook/Instagram account advertising the club or potentially use in a future flyer. Please indicate here yes/no whether or not it is okay to use photos with your child in our marketing.*
- Yes
- No
Emergency contact name:
First Last
Emergency contact phone
Emergency contact email:
Parent Signature*
By typing your name here, you give permission for your son or daughter to participate in the Ultimook Youth Track Club
Date of Application*
MM slash DD slash YYYY