Junior Run Club Registration

"*" indicates required fields

Step 1 of 4 – Child Information

Child's Name*

First Last

Birth Date*

Child's Age*

Select Months Attending*

FAC Members: $65/month; FAC Guests: $75/month

June 2025 (Tuesdays; 4:30pm – 5:15pm)

July 2025 (Tuesdays; 4:30pm – 5:15pm)

Injuries/Medical Conditions?

Other Conditions or Comments?

Primary Parent/ Caregiver Name*

First Last

Primary Parent/ Guardian Cell Phone*

Home Address*

Street Address City State ZIP Code

Primary Caregiver Email*

Secondary Parent/Caregiver Name

First Last

Secondary Caregiver Cell Phone

Home Address

Street Address Address Line 2 State ZIP Code

Secondary Caregiver Email

A Place Where You Belong