1.	What year of school are you?*
	6 7 8 Other

2.	Runner's Last Name*

3.	Runner's First Name* What you generally go by (not a nickname or birthname)

4.	Runner's Nickname We will give you a nickname if you don't already have one...just part of being family. If the nickname you are given makes you uncomfortable please let us know.

5.	Mr Hawley is one of the coaches for Cross Country at Heritage High School. When you are in high school might you be interested in running for the Cross Country team at Heritage High School?*
	-- Please Select --Yes No

6.	What is your best mile time? Enter like 8.16* If you are not sure enter 0 or a best guess time.

7.	What is your best HP 2.5K time? Enter like 8.16* If you are not sure enter 0 or a best guess time.

8.	What is your best XC (3.1 Mile/5K) mile time? Enter like 28.16* If you are not sure or have never ran a 5K enter 0

9.	Are you a*
	M F

10.	What is your birthdate? ie. 04-21-95* Each number must be 2 digit, so 4 is written 04

11.	What is your student ID # for school?* (6 digit lunch number / login number for computers)

12.	Student/Runner Email Address Optional

13.	Parent/Guardian Email Address 1 Parent will be added to Running Club list to send important information throughout the year.

14.	Parent/Guardian Email Address 2 Parent will be added to Running Club list to send important information throughout the year.

15.	Main Parent/Guardian Cell Phone Number ie. 703-779-8675*

16.	Can texts be sent to Main Parent/Guardian phone number?*
	-- Please Select --Yes No

17.	Enter Emergency Contact Info* You must fill in all info for at least 1 guardian, both is prefered... G1=Mother/Guardian1 First and Last Name ie.Jon Doe... G1#= Guardian1 phone number... G2=Father/Guardian2... G2#= Guardian2 phone number
	G1   G1#   G2   G2#

18.	What are your goals for Running Club this year?* You may choose more than 1
	fun    XC Prep    exercise    friends    Other, please specify

19.	What other sport (if any) do you play seriously? Let coaches know, by spoken communication, if you play another sport while in xc season so we can adjust your running schedule/mileage accordingly.

20.	Do you understand you are responsible for reading, knowing, understanding, and abiding by all the information and rules given to students at Running Club? Do you understand that behavior that is not responsible, safe, or unfriendly may cause for you to be asked not to attend Running Club?*
	-- Please Select --Yes No

21.	Do you understand that we will meet in the main gym before and after and that you must get your own ride to the main gym on Running Club mornings at 7AM. You do not have to attend all meetings each week, but you can and are encouraged to attend all meetings. When meeting in the main gym you must sit down and wait for the club to start.*
	-- Please Select --Yes No

22.	What size shirt do you wear?*
	Kids Small Kids Medium Adult Small AdultMedium Adult Large Adult XL

23.	Runners may be running off school grounds and volunteers maybe chaperoning runners at various levels. Volunteers and staff can not be responsible for irresponsible runner's behavior or any injury occurring to a student during Runner's Club. Student's not picked up or dropped off in the times given may be asked to remove themselves from the club. Do the runner and the guardian understand and agree to the above terms?*
	-- Please Select --Yes No

24.	If parent is interested in helping out with the running club please enter the volunteer's name. Volunteering is mostly needed in the form of having 2 eyes (or even 1) that can watch runners as we play games and in the locker rooms. Volunteers may run and play with us, but some also just watch, which is still very helpful. Volunteers are also needed to help organize buying and ordering running shirts and other fund raising items. Volunteers are needed to make awards. Cash donations are also accepted to cover the cost of running the club, buy items for awards and other operational and goal oriented costs. This is not a paid position for the teacher(s) who run it nor is it supported financially by Harper Park Middle School.

25.	If interested in volunteering, enter guardian volunteer email address

26.	If interested in volunteering, enter guardian volunteer phone number

27.	If interested in volunteering, what are you interested in helping with?
	eyes    running    playing games    shirts    awards    Other, please specify

28.	What days might you be interested in volunteering to help? You can change your mind or days available anytime :) right now we are only doing certain am and pm days, but days maybe added later
	ANY AM OR PM    ANY AM    ANY PM    M AM    T AM    W AM    TH AM    F AM    SATAM    M PM    W PM    TH PM

29.	I understand that I should sign up for E-Alerts on the Running Club Website, so that I will get important information about Running Club. And I will make it so steve.hawley@lcps.org emails do not automatically go to trash/junk mail folder.*
	-- Please Select --Yes No

	Don't forget to print out this survey and get it signed by a guardian at the top of the survey before clicking DONE to submit it and turn it into Mr. Hawley at the next Running Club Meeting.