ARIZONA CROSS COUNTRY COACHES ASSOCIATION

By filling out this form and the Arizona Cross Country Association form you are indicating your intentions of wanting to participate in the border war, please answer the questions as they pertain to you and fax them to Coach Steve Johnson at Maryvale High School. The fax number to send in the registration forms is: 602-271-2597. Please try and have this form back to me by Thursday, November 9, 2006 – if not sooner.

NAME ___________________________ AGE _______ DOB ________ GRADE _____

ADDRESS _______________________________________ CITY _________________

ZIP CODE _________ PHONE ____________________ E-MAIL ________________

JERSEY SIZE: S M L XLG

(Students will be wearing their own shorts and shoes for the race)

PARENTAL CONSENT/PARTICIPATION WAVIER

I hereby grant permission for my child to participate in the border war race in Tempe, AZ at Kiwanis Park, Saturday, November 18, 2006. I verify that my child is in good health and able to participate in the race (a certifiable 3.1 mile course by USATF standards). I agree to hold harmless and defend Steve Johnson, Arizona Track & Cross Country Association and New Mexico Track and Cross Country Coaches Associations. Every participant (runners) in the border war will purchase their USATF card (which costs $15.00) which covers them under the USATF affiliation. By being a member it will not violate any infractions or rules related to the AIA. I authorize Arizona Track & Cross Country Coaches Association to render aid or transport my child in case of an emergency.

Parent or Guardian (please print) _____________________________________________

Parent or Guardian Signature ________________________________________________

Athlete (please print) ______________________________________________________

Athlete’s signature ________________________________________________________

In Case of Emergency please call: ___________________________________________

If you have any questions or concerns please call Coach Steve Johnson at Maryvale H.S.

Voice mail # 602-764-2402 or home # 623-322-7564