2022 Aggieland Cross Country Registration
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Athlete's Last name *
Athlete's First Name *
Athlete's Birth Date *
Example:  01/01/2005  (this is used for knowing what division your athlete will compete in for some meets)
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Athlete's Age on Sep. 1, 2022 *
Athlete's Predominant Grade Level *
Mark Only One Oval
Gender *
Mark Only One
Shirt Size (if we order a team t-shirt, we will use the size you submit here) *
Athlete's Email Address
Athlete's Cell
###-###-####
Do you wish to receive text messages on this phone?
Mark Only One
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Number of Years (Seasons) of Participation With Experience with Cross Country or Track (you can estimate, use N/A, etc) *
Parent 1's Last Name *
Parent 1's First Name *
Parent 1's Cell *
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Do you wish to receive text messages on this phone? *
Mark Only One
Parent 1's Email Address *
Parent 2's Last Name
Parent 2's First Name
Parent 2's Cell
###-###-####
Do you wish to receive text message on this phone?
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Parent 2's Email Address
Athlete's Street Address *
Athlete's City *
Athlete's Zip Code *
Person to notify in case of an emergency. *
Last name, First name
Emergency Contact's Phone *
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List any allergies that the runner has (ie. Bees, food), if none, please put NKA *
Are there any medical issues that the coaches should be aware of? If so please describe or indicate you would like to meet personally with the coaches. *
Parent(s) or legal guardian must sign below before player is accepted to participate in AHA Panther Cross Country / Track & Field Activities; As parent/legal guardian of the child named herein, I hereby represent that the child has been examined by a pediatrician and is physically fit to participate in the AHA Panther Cross Country Program.  I understand there are inherent risks to participating in this athletic program.  I hereby accept responsibility for and agree to pay all costs of medical treatment resulting from any injury suffered by my child as a result of his/her participation in the AHA Panther Cross Country Program.  I further agree to indemnify and hold harmless Aggieland Homeschool Athletics, Inc., Aggieland Homeschool Cross Country / Track & Field, as well as AHA Panther Cross Country / Track & Field officers, and its coaches, employees and/or representatives, from any and all liability, damage, or expense arising out of my child's participation in the AHA Panther Cross Country / Track & Field program.  In the event that I cannot be reached in an emergency, I hereby give permission for a AHA Panther Cross Country / Track & Field Program employee, coach, member, an emergency medical technician, a physician or staff member at a hospital, or any other qualified individual to administer care and provide any medical treatment deemed necessary for my child. *
Please sign your name below
Volunteer Help
Please Check One or More
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My child (athlete) read and agrees with the Athlete's Pledge. On p. 18 of the Handbook, located on our website under Documents: http://aggielandhomeschool.com/cross-country *
My child (athlete) read and agrees to abide by the dress code. On website under Uniforms & Supplies page: https://aggielandhomeschool.com/uniforms-supplies-1 *
Please type Childs name in the blank below.
I read and agree with the Parent's Pledge. On p. 19 of the Handbook, located on our website under Documents: http://aggielandhomeschool.com/cross-country *
Please type both parent's names in the blank below.
I read and agree with the Statement of Faith on p. 2 of the Handbook, located on our website: http://aggielandhomeschool.com/cross-country (The Statement of Faith is not required to participate with Aggieland Homeschool Athletics, but is required for voting rights). *
Please type your name below.  Also, enter any objections/corrections.
I request to be a voting member of AHA. *
This may only be requested if the Statement of Faith has been signed.  Please choose yes if you did sign the Statement of Faith and wish to become a voting member of AHA.  Please choose no if you would like your child to participate but do not want to become a voting member of AHA.
I agree to abide by the AHA Complaint/Conflict Policy. (Page 14 of the Handbook) *
Do you have another child/ athlete to register for Cross Country? *
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