Name_____________________________________________________ 

Grade____________________________________________________

What you prefer to be called___________________________________

Birth date _________________________________________________

Parent/Guardian’s Name_______________________________________

Home Phone________________________________________________

Cell Phone_________________________________________________

Email Address: Yours_________________________________________

                        Parents’_______________________________________

Please describe any health problems that I should know about __________________________________________________________________________________________________________________

Do you run on a regular basis (at least 3x/week)             Yes             No

Have you ever run cross country before                          Yes             No

Have you ever lettered in cross country for SVHS?                  Yes             No

Do you play any other sports?                                          Yes             No 

If yes, what and for whom_____________________________________

What’s the longest time/furthest distance you’ve ever run? ____________

Is there anything else you would like me to know about you?