CRC XC Distance Running Camp
Waiver and sign-up sheet
 

Runner info:

First Name:________________________________           Last Name:________________________________

Age:_____  Sex:____  Year in school (upcoming year):________________

High School:______________________ High School coach:________________________

Address:________________________________________   City:_____________  State:_____ Zip:_________

Parent(s) Name:________________________________________________________

Parent(s) Phone:________________________________________________________

Emergency Contact(s) Name:________________________________________________

Emergency Contact(s) Phone:__________________

Allergies, Medications, Special Instructions:_____________________________________________

______________________________________________________________________________

Camp date and site (circle one):      Dublin, Week One (July 14-17)             Westerville, Week Two (July 21-24)

EXTRA: Every camper receives a pair of Mizuno running shorts. You may also buy a T-shirt for an additional $10.
Would you like to buy a T-shirt:         YES              NO              If yes, what size:     S      M      L      XL

Waiver:
In consideration of the acceptance of this entry, I hereby waive and release any and all rights and claims for damages that I or my heirs may have against the Columbus Running Company, the Camp directors, event sponsors and volunteers. I certify that the entrant is medical able and willing to participate in the camp.

Parent/Guardian Signature:___________________________________________ Date:_________________

Please send completed applications and checks made out to Columbus Running Company, $45 per participant to: