100-Mile Club Registration Form

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***Please fill out one form per participant.***

Date *

YYYY

Participant's First Name *

Participant's Last Name *

Grade *

Teacher *

Shirt Size *

Parent's First Name *

Parent's Last Name *

Parent's Email *

Parent's Phone Number *

I can help mark laps on the following mornings: *

Tuesdays

Wednesdays

Thursdays

Occasionally, as my schedule permits

Unavailable

Other:

Required

I plan to make my payment of: *

Submit

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