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Winston-Salem, NC – Sign Up Form (Adult)
$
0.00
Programs
Adult Fall Drop-in Class | One Practice | July 23 - Dec 3
(
+$10.00
)
Adult Winter Training | 2 days/week | January 7th – April 5th
(
+$112.50
)
Adult Winter Training | Tuesdays | January 7th – April 1st
(
+$71.50
)
Adult Winter Training | Saturdays | January 11th – April 5th
(
+$66.00
)
Adult Winter Drop-in Class | One Practice | January 7th – April 5th
(
+$10.00
)
What distance are you training for?
*
Choose an option
Full Marathon
Half Marathon
8k
5k
Athlete Name
*
Email Address
*
Phone
*
Age
*
Gender
*
Male
Female
Shirt Size
*
Choose an option
Youth Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult 2X
How did you hear about us?
Returner
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Emergency Contact
*
Emergency Contact Phone
*
Photo Release
by Crazy Running Franchising LLC and any franchisee of Crazy Running Franchising LLC for marketing purposes, including but not limited to: still photography, videotape, electronic and print publications and websites. I give this consent with no claim for payment. I DO consent to the use any visual image of myself.
Please initial to consent to use of photographs, video, etc.
Waiver
In consideration of this application being accepted, I certify that I am the parent or legal guardian of the above named participant (“Minor”), a minor, and hereby consent to his/her participation in the Crazy Running program. I hereby waive and release any and all claims that I may have, or that my child may have, against Crazy Running LLC (an independently owned and operated franchisee of Crazy Running Franchising LLC), Donald Cowart, Jessica Cowart, Justin Pfruender, Cheryl Pfruender and any other coaches or staff (“Releasees”) from any and all liability, claim, judgment, loss, costs and expenses arising out of any illness or injury that my child or I may incur or sustain during the program. I have had the opportunity to inspect the premises used for practices and am satisfied with its condition. I understand that, in the event of an injury or illness of my child, a representative of Crazy Running, LLC will try to notify me or another emergency contact first. In the event that I or another emergency contact cannot be reached, I authorize Crazy Running LLC to obtain necessary medical treatment for Minor and hereby, in my own behalf, release and hold harmless Releasees in the exercise of this authority. I also accept full financial responsibility for such care. I acknowledge that the Minor suffers from the following conditions that may be important for the Crazy Running coaches to be aware of:
Are there any physical, emotional or social issues that we should be aware of that might affect how you interact in a group setting or affect participation?
I hereby warrant that I have read this Participant Release and Waiver and understand its contents. I hearby authorize and consent to the use of:
My Visual Image
*
Yes
No
Can we add you to our mass email (typically sent once per month)?
*
Yes
No
Waiver Signature
*
Refund Policy:
Due to changes in our payment processing provider's policies, in the event of needing a refund, we are now forced to charge $11 per program refunded.
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Winston-Salem, NC - Sign Up Form (Adult) quantity
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Category:
Crazy Running - WSNC Adult
Description
Description
For more information on our offerings:
Youth Programs
Winter
Spring
Summer
Fall
Elite Group
Races
Personal Training
Other
Adult Group Training
Personal Training
Questions? Email
us
!