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Cross Country Student-Athlete Questionnaire 2022
Please provide Student's Pender County Schools Email including the @
stu.pender.k12.nc.us
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* Indicates required question
Email
*
Your email
You can sign up for updates on Remind by texting @topsailcc to phone number 81010. Returning runners, if you are already signed up, you do not need to sign up again.
Student Last Name
*
Your answer
First Name
*
Your answer
Middle Initial
*
Your answer
Preferred Name
Your answer
Male/Female
*
Choose
Male
Female
Grade (For 2021-2022 school year)
*
Choose
9
10
11
12
Birth date
*
MM
/
DD
/
YYYY
Athlete's Home Address
*
Your answer
Athlete Cell Phone (optional)
Your answer
Parent/Guardian #1 Name
*
Your answer
Parent/Guardian #1 Address
*
Your answer
Parent/Guardian #1 Email (If none, leave blank)
Your answer
Parent/Guardian #1 Cell Phone
*
Your answer
Parent/Guardian #1 Home Phone (If none, put N/A)
*
Your answer
Parent/Guardian #1 Work Phone (If none, put N/A)
*
Your answer
Parent/Guardian # 2 Name
Your answer
Parent/Guardian #2 Address (If different)
Your answer
Parent/Guardian #2 Email (if none, leave blank)
Your answer
Parent/Guardian #2 Cell Phone
Your answer
Parent/Guardian #2 Home Phone (If different)
Your answer
Parent/Guardian #2 Work Phone
Your answer
Parent/Guardian #2 Work Phone (If none, put N/A)
Your answer
Are you planning to take classes off campus next year?
*
Choose
Yes
No
Are you planning to attend school in-person or virtually next year?
*
In-person
Virtually
Unsure
Years on Team
*
Choose
0
1
2
3
Uniform Top Size
*
Choose
XS
S
M
L
XL
XXL
Unsure
Uniform Bottom Size
*
Choose
XS
S
M
L
XL
XXL
Unsure
How long have you been running?
*
Choose
Just started/Haven't run in over a year
Less than 1 year
1-2 years
3-4 years
More than 5 years
What is your 5K Personal Record?
*
Choose
Unknown/Never Ran a 5K
Over 30:00
25:00-29:59
22:00-24:59
20:00-21:59
18:30-19:59
17:00-18:29
16:00-16:59
Faster than 16:00
How many miles per week are you currently running (average)?
*
Choose
0-5 Miles
6-10 Miles
11-20 Miles
21-30 Miles
31-40 Miles
41-60 Miles
61-75 Miles
More than 75
What other sports have you participated in at Topsail HS? List what years you participated in each sport as well and whether you earned a Varsity letter.
*
Your answer
What other athletic experience do you have?
Your answer
Please list any medical concerns we need to know about
Your answer
Do you have any activities, jobs, organizations, other sports, etc. that might interfere with daily Cross Country practices and meets? Please list and describe how it might interfere?
Your answer
Anything else you would like us to know
Your answer
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