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Go the Distance Interest Questionnaire
Please fill out the information below so that we may contact you regarding the Go the Distance (Run/Walk Club) Thanks! ---Teachers and Club Sponsors Ms. Kirstin Jones & Ms. Kelly Vigon
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First Name
*
Your answer
Last Name
*
Your answer
Current Grade Level
*
9th
10th
11th
12th
Teacher
Birthday
*
MM
/
DD
/
YYYY
School E-mail Address
*
Your answer
Parent Name
*
Your answer
Parent's email address
*
Your answer
Parent's cell phone number
*
Your answer
Do you have reliable transportation for pick up after club participation? (T/Th 3:30 pm-4:30 pm)
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Yes
No
Other:
Will you be able to sign up for REMIND to receive important information?
*
Yes
No
Do you have any medical conditions that will prevent or limit your participation in club activities?
*
Yes
No
Other:
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