Registration - Fit180 Athletics

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Step 1 of 5 - Athlete Information

Phone

This field is for validation purposes and should be left unchanged.

Cross Conditioning*

Price:

Athlete's Information

Please fill out all of the required fields in this section.

Athlete's Name*

First Last

Gender*

Male

Female

Date of Birth*

MM slash DD slash YYYY

School*

Grade*

First Time Registration?*

This is the FIRST TIME my athlete has participated in ANY Fit180 Program

Athlete HAS PARTICIPATED in a former Fit180 program.

If you have already completed a registration for this athlete for a former program, you can choose to SKIP or UPDATE your Contact and Medical Information.

Has Your Medical and Insurance Information Changed?*

NO. My Medical Information has not Changed. Skip this section.

Yes. I need to UPDATE or PROVIDE medical information

IMPORTANT: This includes relevant conditions, critical allergies, over-the-counter medication, prescriptions, insurance and Doctor information. If nothing has changed since your last registration, please select No.

Contact Information

Contact information is for advising and coordination of program information. This information is kept private and is not sold or offered to any 3rd party.

Primary Email Address (Parent or Guardian)*

Enter Email Confirm Email

Additional Email Address (Optional)

Enter Email Confirm Email

Please enter any additional email that you would like to be included in the correspondence.

Mother's Name

First Last

Mother's Cell Phone

Father's Name

First Last

Father's Cell Phone

Other Authorized Guardian*

All authorized guardians are listed above

I wish to authorize another authorized guardian for pickup/drop-off

Guardian's Name

First Last

Cell (Additional Guardian)

Medical Information

Please fill out all fields in this section

Medical or Allergy Conditions*

My child has NO medical or allergic conditions that you need to be aware of.

My child has a medical or allergic condition you need to be aware of.

By signing this form, you are affirming that our child is medically and physically fit to take part in strenuous exercise. However, if there is anything we should know regarding allergies, medicine, or medical conditions, please select the second option and let us know.

Please list anything your child is allergic to (drugs, pollen, nuts, etc):*

Does your child have any of the following?

Asthma (incl. exercise-induced asthma)

Diabetes

Epilepsy

Is your child currently taking any medications that we should be aware of?*

Yes

Please list those medications:*

Is there additional information we should know about your child's health or physical condition?*

Yes

Also use this to explain any conditions listed above.

Please explain:*

Insurance Information

Please fill out all fields in this section.

Name of Insurance Company*

Policy Name and Number*

Physician's Name*

First Last

Dr's Phone*

Informed Consent and Terms & Conditions

Authorization for participation and emergency treatment.*

I hereby give permission for my athlete (Named Above), to participate in Fit180 Athletics programs. Further, I authorize the club to provide emergency treatment of any injury or illness my child may experience if qualified medical personnel consider treatment necessary and perform the treatment. This authorization is granted only if I cannot be reached and reasonable effort has been made to do so. My child and I are aware that participating in conditioning, track and field and cross country is a potentially hazardous activity. We assume all risks associated with participation in this sport, including, but not limited to falls, contact with other participants and other reasonable-risk conditions associated with the sport. All such risks to my child are known and understood by my child and me. We understand this informed consent form and agree to its conditions.

Risk Acknowledgement and Release*

I agree that by signing this form, that my minor athlete is a member of Fit180 Athletics (hereinafter “the club”), and I know that running in and volunteering for organized group runs, social events, and races associate with the club are potentially hazardous activities, which could cause injury or death. I will not allow my minor athlete to participate in any club organized events, group training runs or social events, unless he or she is medically able and properly trained, and by my signature, I certify that my minor athlete is medically able to perform all activities associated with the club and is in good health, and properly trained. I agree to abide by all rules established by the club, including the right of any official or coach to deny or suspend my participation for any reason whatsoever. I attest that I have read the rules of the club and agree to abide by them. I assume all risks associated with my minor athlete being a member of the club and participating in all club activities, which may include but no limited to: falls, physical contact with other participants/members, volunteers, race personnel, contract service providers, employees, and spectators including the potential the contraction of a communicable disease resulting from contact with other participants/members, volunteers, race personnel, contract service providers, employees, and spectators. I assume all risks including: the effects of the weather; high heat and/or humidity; freezing cold temperatures; traffic and the conditions of the road including surrounding terrain. I further agree to abide by the Center for Disease Control’s (CDC) recommendations for the prevention of the spread of the 2019 Novel Coronavirus Disease (COVID-19) and other communicable diseases, and I attest to having read the CDC’s guidance at: https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html. I assume all such risks being known, appreciated, and accepted by me. I understand that bicycles, skateboards, baby joggers/strollers, roller skates or inline skates, animals, and personal music players are not allowed in club organized runs or events, and I will abide by all rules of the club. Having read this waiver and knowing these facts and in consideration of your accepting my minor athlete’s membership, I, for myself and anyone entitled to act on my behalf, waive and release Fit180 Athletics and the Road Runners Club of America, all club sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in the club activities, even though that liability may arise out of negligence or carelessness on the part of the persons or organizations named in this waiver. In addition, I acknowledge the contagious nature of COVID-19 and other communicable diseases and voluntarily assume the risk that my minor athlete may be exposed to or infected by COVID-19 and/or other communicable diseases by participating in any activities associate with the club. I acknowledge that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 in connection with my participation in any club activities, and personally assume this risk.

Image Release*

In consideration of my minor child/ward being allowed to participate in any way in the Fit180 Athletics Club program, related events and activities, the undersigned agrees that such participants’ likeness may be photographed or videotaped and that such image may be published in our outlet used to promote or publicize the sports program.

Terms and Conditions

CODE OF CONDUCT Parents • Be a positive role model. • Encourage good sportsmanship among all athletes. • Be supportive of coaches and meet officials. • Respect the coach’s ability to teach and coach your child. Parents may discuss the training program with coaches following practice, if time permits. It is recommended that parents schedule time separate from practice to meet with the coach to discuss concerns. • Arrive to meets at the time given to you by the coach and check in at the designated team area. • Place the physical and emotional well-being of your child above any personal desire that they have to win. • Remember, children are involved in organized sports for their enjoyment, not ours. Be supportive and encourage them to enjoy themselves and to do their best. Athletes • Arrive at practice ready to listen, work hard, learn and give my best effort. • Do your best to be at every scheduled practice. Be on time and prepared. Late athletes will not be allowed to participate in training activities without completing a warm-up. Practices will not be delayed or extended to accommodate late arrivals. • Learn the rules and always compete by them. • Be respectful of coaches, officials, parents, teammates and competitors on other teams. Treat others as you wish to be treated. • Inappropriate behavior and/or language will not be tolerated. Conduct which is not in compliance with the Code of Conduct and/or which is detrimental to the club may result in an athlete's dismissal from the club. FEES WILL NOT BE REFUNDED IN THE EVENT OF DISMISSAL

CANCELLATION POLICY for all Fit180 Programs. Cancellation Fee: There will be a $20 Cancellation Fee for any refund of funds at any time after payment has been received. Maximum Refund will be: (a) If more than 48 hours prior to the start of the program, you will receive a full refund, minus cancellation fee (above), and any other expenses that have been applied, such as uniforms, race fees, etc.., or (b) if after 48 hours prior to start of the program, Maximum refund will be 50% of total program fees. Fit180 Athletics holds the right to further prorate the refund based on the actual participation of the athlete, and expenses incurred. At no time will the refund be greater than 50% of total program fees.

Signature of parent or guardian*

Type in your full name for an electronic signature. By signing above, you agree to the Terms and Conditions, Image Release, and Authorization for Participation as detailed above.

Almost Done! Just one more step

Options and Payment

Please select from the options below for Uniforms, Spirit Wear, and Payment Method.

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Uniform

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UNIFORM*

This program requires that each athlete wear a Fit180 Team uniform on day of race. Image: Fit180 Uniform

I need to Buy a Uniform

Already Have a Fit180 Uniform

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Uniform Size*

Jersey*

Black/White Fit180 Racing Jersey

Jersey - $25

Already Have a Jersey

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Black Shorts*

For this program, athletes may wear their own Black athletic shorts if they choose. Or they may order our shorts here.

Shorts - $20

Already have shorts

Payment Method

Did you receive a unique registration code?

Total

Credit Card*

Cardholder Name

Card Details

Billing Address*

Street Address Address Line 2 City State ZIP Code

"*" indicates required fields

Step 1 of 6 - Athlete Information

Facebook

This field is for validation purposes and should be left unchanged.

Program Selection

Please select the program options for your athlete

Select Your Option

South Charlotte MS

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Add Pre-Conditioning?*

Available at Community House Location Only.

Yes, you can register for South Charlotte location for Standard Season, and still do Pre-Conditioning at Community House.

Pre-Conditioning

No Pre-Conditioning

Athlete's Information

Please fill out all of the required fields in this section.

Athlete's Name*

First Last

Gender*

Male

Female

Date of Birth*

Birthday of Athlete

MM slash DD slash YYYY

Qualification*

My School does not have a cross-country program

I am a homeschool athlete

Fit180 XC is open to homeschoolers and athletes attending schools that have no cross country program. Athletes must qualify under one of the above choices.

School*

Grade*

First Time Registration?*

If you have already completed a registration for this athlete for a former program, you can choose to SKIP or UPDATE your Contact and Medical Information.

This is the FIRST TIME my athlete has participated in any Fit180 Program

Athlete HAS PARTICIPATED in a former Fit180 program.

Has Your Medical and Insurance Information Changed?*

This includes relevant conditions, critical allergies, over-the-counter medication, insurance and Doctor information. If nothing has changed since your last registration, please select No.

NO. My Medical Information has not Changed. Skip this section.

Yes. I need to UPDATE or PROVIDE medical information

Contact Information

Contact information is for advising and coordination of program information. This information is kept private and is not sold or offered to any 3rd party.

Primary Email : Parent/Guardian*

Enter Email Confirm Email

Additional Email (Optional)

Enter Email Confirm Email

Parent Information

Mother's Name

First Last

Mother's Cell

Father's Name

First Last

Father's Cell Phone

Other Authorized Guardian*

All authorized guardians are listed above

I wish to authorize another authorized guardian for pickup/drop-off

Guardian's Name

First Last

Cell (Additional Guardian)

Medical & Insurance Info

Medical Information

Please fill out all fields in this section

Medical or Allergy Conditions*

My child has NO medical or allergic conditions that you need to be aware of.

My child has a medical or allergic condition you need to be aware of.

Please list anything your child is allergic to (drugs, pollen, nuts, etc):*

Does your child have any of the following?

Asthma (incl. exercise-induced asthma)

Diabetes

Epilepsy

Is your child currently taking any medications that we should be aware of?*

Yes

Please list those medications:*

Is there additional information we should know about your child's health or physical condition?*

Yes

Also use this to explain any conditions listed above.

Please explain:*

Insurance Information

Please fill out all fields in this section.

Name of Insurance Company*

Policy Name and Number*

Physician's Name*

First Last

Dr's Phone*

Informed Consent and Terms & Conditions

Authorization for participation and emergency treatment.*

Risk Acknowledgement and Release.*

Image Release*

Terms and Conditions

Signature of parent or guardian*

Type in your full name for an electronic signature. By signing above, you agree to the Terms and Conditions, Image Release, and Authorization for Participation as detailed above.

Options and Payment

Please select from the options below for Uniforms, Spirit Wear, and Payment Method.

FREE T-Shirt

This program includes a FREE T-Shirt for your athlete. Brand, Color, and Style may vary from year to year.

T-Shirt*

T-Shirt - FREE

No Thanks

T-Shirt Size*

Uniform

UNIFORM*

This program requires that each athlete wear a Fit180 Team Uniform (Jersey & Shorts) on day of race.

I need to buy a Uniform

Already have a Fit180 Uniform

Jersey*

Black & White Fit180 Jersey

Jersey - $40

Already Have a Jersey

Jersey Size*

Spirit Wear (Optional)
The following items are optional spirit wear items that are commonly purchased by our athletes. If you would like additional items (for parents or siblings), please contact Lisa directly at Lisa@fit180Athletics.com.

Personalized Hoodie

Great for staying warm while hanging out at the tent.

Order Hoodie*

Hoodie - $40

No Thanks

Hoodie Size*

Personalization*

What name do you want printed on the back? Default is your LAST NAME

Payment Information

Did you receive a unique registration code?

Total

Credit Card*

Cardholder Name

Card Details

Billing Address*

Street Address Address Line 2 City State ZIP Code

"*" indicates required fields

Step 1 of 6 - Athlete Information

Instagram

This field is for validation purposes and should be left unchanged.

Summer Conditioning at Marvin Efird Park*

Price:

Athlete's Information

Please fill out all of the required fields in this section.

Athlete's Name*

First Last

Gender*

Male

Female

Date of Birth*

MM slash DD slash YYYY

School*

Grade*

First Time Registration?*

This is the FIRST TIME my athlete has participated in any Fit180 Program

Athlete HAS PARTICIPATED in a former Fit180 program.

If you have already completed a registration for this athlete for a former program, you can choose to SKIP or UPDATE your Contact and Medical Information.

Has Your Medical and Insurance Information Changed?*

NO. My Medical Information has not Changed. Skip this section.

Yes. I need to UPDATE or PROVIDE medical information

This includes relevant conditions, critical allergies, over-the-counter medication, insurance and Doctor information. If nothing has changed since your last registration, please select No.

Contact Information

Primary Contact Email*

For notifying parent/guardian of program changes and updates.

Enter Email Confirm Email

Additional Email Address (Optional)

Additional contact you would like notified for program changes and updates.

Enter Email Confirm Email

Mother's Name

First Last

Mother's Cell

Father's Name

First Last

Father's Cell

Athlete's Home Address*

Street Address Address Line 2 City State ZIP Code

Other Authorized Guardian*

All authorized guardians are listed above

I wish to authorize another authorized guardian for pickup/drop-off

Guardian's Name

First Last

Cell (Additional Guardian)

Medical & Insurance Info

Medical Information

Please fill out all fields in this section

Medical or Allergy Conditions*

My child has NO medical or allergic conditions that you need to be aware of.

My child has a medical or allergic condition you need to be aware of.

Please list anything your child is allergic to (drugs, pollen, nuts, etc):*

Does your child have any of the following?

Asthma (incl. exercise-induced asthma)

Diabetes

Epilepsy

Is your child currently taking any medications that we should be aware of?*

Yes

Please list those medications:*

Is there additional information we should know about your child's health or physical condition, that would affect his/her safe participation in this program?*

Also use this to explain any conditions listed above.

Yes

Please explain:*

Insurance Information

Please fill out all fields in this section.

Name of Insurance Company*

Policy Name and Number*

Physician's Name*

First Last

Dr's Phone*

Informed Consent and Terms & Conditions

Authorization for participation and emergency treatment.*

Risk Acknowledgement and Release*

Image Release*

Terms and Conditions

Signature of parent or guardian*

Type in your full name for an electronic signature. By signing above, you agree to the Terms and Conditions, Image Release, and Authorization for Participation as detailed above.

Payment

Did you receive a unique registration code?

Total Cost

Credit Card*

Cardholder Name

Card Details

Billing Address*

Street Address Address Line 2 City State ZIP Code

"*" indicates required fields

Step 1 of 5 - Athlete Information

X/Twitter

This field is for validation purposes and should be left unchanged.

WinterFit Location*

Marvin Efird Park (2 Weeks) $89.00

South Charlotte MS (4 Weeks) $139.00

Athlete's Information

Please fill out all of the required fields in this section.

Athlete's Name*

First Last

Gender*

Male

Female

Date of Birth*

MM slash DD slash YYYY

School*

Grade*

First Time Registration?*

This is the FIRST TIME my athlete has participated in any Fit180 Program

Athlete HAS PARTICIPATED in a former Fit180 program.

If you have already completed a registration for this athlete for a former program, you can choose to SKIP or UPDATE your Contact and Medical Information.

Has Your Medical and Insurance Information Changed?*

NO. My Medical Information has not Changed. Skip this section.

Yes. I need to UPDATE or PROVIDE medical information

This includes relevant conditions, critical allergies, over-the-counter medication, insurance and Doctor information. If nothing has changed since your last registration, please select No.

Contact Information

Primary Email Address*

Enter Email Confirm Email

Additional Email Address (Optional)

Enter Email Confirm Email

Please enter any additional email that you would like to be included in the correspondence.

Mother's Name

First Last

Mother's Cell Phone

Father's Name

First Last

Father's Cell Phone

Other Authorized Guardian*

All authorized guardians are listed above

I wish to authorize another authorized guardian for pickup/drop-off

Guardian's Name

First Last

Cell (Additional Guardian)

Medical & Insurance Info

Medical Information

Please fill out all fields in this section

Medical or Allergy Conditions*

My child has NO medical or allergic conditions that you need to be aware of.

My child has a medical or allergic condition you need to be aware of.

Please list anything your child is allergic to (drugs, pollen, nuts, etc):*

Does your child have any of the following?

Asthma (incl. exercise-induced asthma)

Diabetes

Epilepsy

Is your child currently taking any medications that we should be aware of?*

Yes

Please list those medications:*

Is there additional information we should know about your child's health or physical condition?*

Yes

Also use this to explain any conditions listed above.

Please explain:*

Insurance Information

Please fill out all fields in this section.

Name of Insurance Company*

Policy Name and Number*

Physician's Name*

First Last

Dr's Phone*

Informed Consent and Terms & Conditions

Authorization for participation and emergency treatment.*

Risk Acknowledgement and Release*

Image Release*

Terms and Conditions

Signature of parent or guardian*

Type in your full name for an electronic signature. By signing above, you agree to the Terms and Conditions, Image Release, and Authorization for Participation as detailed above.

Options and Payment Method

Did you receive a unique registration code?

Total

Billing Address*

Street Address Address Line 2 City State ZIP Code

Credit Card*

Cardholder Name

Card Details

"*" indicates required fields

Step 1 of 5 - Athlete Information

URL

This field is for validation purposes and should be left unchanged.

Program Selection

Fall Conditioning*

Price:

Select Location*

Select which location you would like to attend.

Marvin Efird Park

Athlete's Information

Please fill out all of the required fields in this section.

Athlete's Name*

First Last

Gender*

Male

Female

Date of Birth*

MM slash DD slash YYYY

School*

Grade*

First Time Registration?*

This is the FIRST TIME my athlete has participated in any Fit180 Program

Athlete HAS PARTICIPATED in a former Fit180 program.

If you have already completed a registration for this athlete for a former program, you can choose to SKIP or UPDATE your Contact and Medical Information.

Has Your Medical and Insurance Information Changed?*

NO. My Medical Information has not Changed. Skip this section.

Yes. I need to UPDATE or PROVIDE medical information

This includes relevant conditions, critical allergies, over-the-counter medication, insurance and Doctor information. If nothing has changed since your last registration, please select No.

Contact Information

Primary Email Address*

Enter Email Confirm Email

Additional Email Address (Optional)

Enter Email Confirm Email

Please enter any additional email that you would like to be included in the correspondence.

Mother's Name

First Last

Mother's Cell Phone

Father's Name

First Last

Father's Cell Phone

Other Authorized Guardian*

All authorized guardians are listed above

I wish to authorize another authorized guardian for pickup/drop-off

Guardian's Name

First Last

Cell (Additional Guardian)

Medical & Insurance Info

Medical Information

Please fill out all fields in this section

Medical or Allergy Conditions*

My child has NO medical or allergic conditions that you need to be aware of.

My child has a medical or allergic condition you need to be aware of.

Please list anything your child is allergic to (drugs, pollen, nuts, etc):*

Does your child have any of the following?

Asthma (incl. exercise-induced asthma)

Diabetes

Epilepsy

Is your child currently taking any medications that we should be aware of?*

Yes

Please list those medications:*

Is there additional information we should know about your child's health or physical condition?*

Yes

Also use this to explain any conditions listed above.

Please explain:*

Insurance Information

Please fill out all fields in this section.

Name of Insurance Company*

Policy Name and Number*

Physician's Name*

First Last

Dr's Phone

Informed Consent and Terms & Conditions

Authorization for participation and emergency treatment.*

Risk Acknowledgement and Release*

Image Release*

Terms and Conditions

Signature of parent or guardian*

Type in your full name for an electronic signature. By signing above, you agree to the Terms and Conditions, Image Release, and Authorization for Participation as detailed above.

Payment Information

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FREE T-Shirt

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Free T-Shirt

Free T-shirt

Yes, I would like a free T-Shirt. Select size below.

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T-Shirt Size*

Did you receive a unique registration code?

Total

Billing Address*

Street Address Address Line 2 City State ZIP Code

Credit Card*

Cardholder Name

Card Details

"*" indicates required fields

Step 1 of 5 - Athlete Information

20%

Company

This field is for validation purposes and should be left unchanged.

Junior Olympics XC*

Early registration ended on Monday, October 20.

Price:

Location*

Charlotte Latin

Monday, Wednesday at Weddington
Friday at Charlotte Latin
Practice Times: 4:30 - 6:00

Athlete's Information

Please fill out all of the required fields in this section.

Athlete's Name*

First Last

Gender*

Male

Female

Date of Birth*

MM slash DD slash YYYY

School*

Grade*

USATF MEMBERSHIP

USATF #*

A Current USATF Membership number must be obtained prior to participation in a USATF event. This number must be linked to Fit180 Athletics. Visit the USATF website to obtain this number.

I Have a USATF Number

I Need to get my USATF Number

USATF Membership #*

IMPORTANT: Make sure your USATF # is attached to FIT180 and is not EXPIRED.

IMPORTANT: InstructionS for Obtaining a USATF # and Age Verification.

To obtain a USATF #, visit the USATF website:

Step 1- go to www.usatf.org

Step 2- In the top banner of the page (Or pull-down menu) click on "Membership" and then “Join” under the Individual Youth Membership column.

Step 3- Select an Email and secure password for your account.

Step 4- Fill out the form completely under “New Membership”

Very Important:
* Under Membership Type, select Youth Membership
* For Club Affiliation, select Fit180 Athletics or club number “906”. If you do not put this code in, the athlete will not be listed under our team.
* Under “Membership Categories” Check “Athlete”
* Membership Year is “2020-2021 year”

Step 5 – Complete and pay for registration. ($26.50)

FOR ATHLETE’S COMING FROM OTHER PROGRAMS

Please Note: If your athlete is coming from another team. You will be require to send an email to “membership@usatfga.org”

The letter must read:
To whom this may concern. I want to move “Athletes Name and USATF Membership Number” from “prior clubs name” to “Fit180 Athletics Club- 906” Athlete has not competed with prior club in over 90 days

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Instruction for Obtaining an AAU #

To obtain a AAU #:
Visit AAU Website Registration
Select your sport: Track and Field (cross country)
Are you a member of a club? YES
Find and select Fit180 Athletics
Complete athlete and payment information.

The system will provide payment confirmation and member #

Age Verification USATF

Members are required to upload/submit their birthdate verification documents while completing their membership profile on the USATF Connect system. This only needs to be done once. If you’ve done this in the past you don’t need to do it again. Athletes can NOT compete in the qualifying JO meet without being age verified.

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Age Verification AAU

Athletes are required to present age verification prior to running an AAU event. You will be asked to bring a copy of your athletes birth certificate or passport to each AAU event.

Age Verification*

My Athlete is Already Age Verified

I will make sure my athlete is Age Verified according to the instructions above.

First Time Registration?*

If you have already completed a registration for this athlete for a former program, you can choose to SKIP or UPDATE your Contact and Medical Information.

This is the FIRST TIME my athlete has participated in any Fit180 Program

Athlete HAS PARTICIPATED in a former Fit180 program.

Has Your Medical and Insurance Information Changed?*

This includes relevant conditions, critical allergies, over-the-counter medication, insurance and Doctor information. If nothing has changed since your last registration, please select No.

NO. My Medical Information has not Changed. Skip this section.

Yes. I need to UPDATE or PROVIDE medical information

Contact Information

Contact information is for advising and coordination of program information. This information is kept private and is not sold or offered to any 3rd party.

Primary Email Address*

Enter Email Confirm Email

Additional Email Address (Optional)

Please enter any additional email that you would like to be included in the correspondence.

Enter Email Confirm Email

Mother's Name

First Last

Mother's Cell Phone

Father's Name

First Last

Father's Cell Phone

Athlete's Address*

Street Address Address Line 2 City State ZIP Code

Other Authorized Guardian*

All authorized guardians are listed above

I wish to authorize another authorized guardian for pickup/drop-off

Guardian's Name

First Last

Cell (Additional Guardian)

Medical & Insurance Info

Medical Information

Please fill out all fields in this section

Medical or Allergy Conditions*

My child has NO medical or allergic conditions that you need to be aware of.

My child has a medical or allergic condition you need to be aware of.

Please list anything your child is allergic to (drugs, pollen, nuts, etc) that our coaches should be aware of:*

Does your child have any of the following?

Asthma (incl. exercise-induced asthma)

Diabetes

Epilepsy

Is your child currently taking any medications that we should be aware of?*

Yes

Please list those medications:*

Is there additional information we should know about your child's health or physical condition?*

Yes

Also use this to explain any conditions listed above.

Please explain:*

Insurance Information

Please fill out all fields in this section.

Name of Insurance Company*

Policy Name and Number*

Physician's Name*

First Last

Dr's Phone*

Informed Consent and Terms & Conditions

Authorization for participation and emergency treatment.*

Risk Acknowledgement and Release*

Image Release*

Terms and Conditions

Signature of parent or guardian*

Type in your full name for an electronic signature. By signing above, you agree to the Terms and Conditions, Image Release, and Authorization for Participation as detailed above.

Options and Payment

FREE Long Sleeve Team Shirt

Color, Brand, and Style may vary from year to year.

Long Sleeve Team Shirt*

Long Sleeve - Included FREE

No Thanks

Long Sleeve Size*

Uniform

UNIFORM*

This program requires that each athlete wear a FIT180 Team Uniform (Jersey & Shorts) on day of race.

I Need to Buy a Uniform

Already Have a FIT180 Uniform

Jersey*

Black & White Fit180 Jersey

Jersey - $40

Already have Fit180 Jersey

Jersey Size*

This field is hidden when viewing the form

Shorts*

Black & White Fit180 Shorts

Shorts - $20

Already have Fit180 Shorts

Shorts Size*

SPIRIT WEAR (Optional)

If you would like ADDITIONAL orders for other family members, please contact Lisa directly at Lisa@Fit180Athletics.com.

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Personalized Hoodie

Great for staying warm while hanging out at the tent.
Important: Due to shipping times, orders must be received by Oct 27.

This field is hidden when viewing the form

Hoodie

100% Cotton hoodie
Front thru-pocket
Name on back

Hoodie - $40

No Thanks

Hoodie Size*

Note: Youth sizes tend to run SMALL

Your hoodie will come personalized with the Athlete's last name as he was registered. If you would like something other than this, please contact Lisa directly.

Payment

Did you receive a unique registration code?

Total

Billing Address*

Street Address Address Line 2 City State ZIP Code

Credit Card*

Cardholder Name

Card Details

"*" indicates required fields

Step 1 of 6 - Athlete Information

Name

This field is for validation purposes and should be left unchanged.

Program Selection

Please select the program options for your athlete.

XC Elementary*

Price:

Athlete's Information

Please fill out all of the required fields in this section.

Athlete's Name*

First Last

Gender*

Male

Female

Date of Birth*

MM slash DD slash YYYY

School*

Grade*

First Time Registration?*

This is the FIRST TIME my athlete has participated in ANY Fit180 Program

Athlete HAS PARTICIPATED in a former Fit180 program.

If you have already completed a registration for this athlete for a former program, you can choose to SKIP or UPDATE your Contact and Medical Information.

Has Your Medical and Insurance Information Changed?*

NO. My Medical Information has not Changed. Skip this section.

Yes. I need to UPDATE or PROVIDE medical information

Contact Information

Contact information is for advising and coordination of program information. This information is kept private and is not sold or offered to any 3rd party.

Primary Email Address (Parent or Guardian)*

Enter Email Confirm Email

Additional Email Address (Optional)

Enter Email Confirm Email

Please enter any additional email that you would like to be included in the correspondence.

Mother's Name

First Last

Mother's Cell Phone

Father's Name

First Last

Father's Cell Phone

Other Authorized Guardian*

All authorized guardians are listed above

I wish to authorize another authorized guardian for pickup/drop-off

Guardian's Name

First Last

Cell (Additional Guardian)

Medical Information

Please fill out all fields in this section

Medical or Allergy Conditions*

My child has NO medical or allergic conditions that you need to be aware of.

My child has a medical or allergic condition you need to be aware of.

Please list anything your child is allergic to (drugs, pollen, nuts, etc):*

Does your child have any of the following?

Asthma (incl. exercise-induced asthma)

Diabetes

Epilepsy

Is your child currently taking any medications that we should be aware of?*

Yes

Please list those medications:*

Is there additional information we should know about your child's health or physical condition?*

Yes

Also use this to explain any conditions listed above.

Please explain:*

Insurance Information

Please fill out all fields in this section.

Name of Insurance Company*

Policy Name and Number*

Physician's Name*

First Last

Dr's Phone*

Informed Consent and Terms & Conditions

Authorization for participation and emergency treatment.*

Risk Acknowledgement and Release*

Image Release*

Terms and Conditions

Signature of parent or guardian*

Type in your full name for an electronic signature. By signing above, you agree to the Terms and Conditions, Image Release, and Authorization for Participation as detailed above.

Almost Done! Just one more step

Options and Payment

Please select from the options below for Uniforms, Spirit Wear, and Payment Method.

FREE T-Shirt

This program includes a free T-shirt for your athlete. Brand, Color and Style will vary from year to year.

Free T-Shirt

Yes, I would like a free T-Shirt. Select size below.

Free T-Shirt

T-Shirt Size*

Uniform

UNIFORM*

This program requires that each athlete wear a Fit180 Team uniform on day of race.

I need to Buy a Uniform

Already Have a Fit180 Uniform

Uniform Size*

Jersey*

Black/White Fit180 Racing Jersey

Jersey - $40

Already Have a Jersey

Spirit Wear (Optional)

If you would like ADDITIONAL orders for other family members, please contact Lisa directly at Lisa@Fit180Athletics.com.

Personalized Hoodie

Hoodie*

100% Cotton Hoodie Front thru-pocket Personalized name on back

Hoodie - $40

No thanks

Hoodie Size*

Personalization*

What name do you want on the back? If nothing is provided, the athlete's last name will be used (as entered above).

Payment Method

Did you receive a unique registration code?

Total

Billing Address*

Street Address Address Line 2 City State ZIP Code

Credit Card*

Cardholder Name

Card Details

"*" indicates required fields

Step 1 of 5 - Athlete Information

Instagram

This field is for validation purposes and should be left unchanged.

RunFit Spring*

Price:

Location*

Marvin Efird Park

Athlete's Information

Please fill out all of the required fields in this section.

Athlete's Name*

First Last

Gender*

Male

Female

Date of Birth*

MM slash DD slash YYYY

School*

Grade*

First Time Registration?*

This is the FIRST TIME my athlete has participated in ANY Fit180 Program

Athlete HAS PARTICIPATED in a former Fit180 program.

If you have already completed a registration for this athlete for a former program, you can choose to SKIP or UPDATE your Contact and Medical Information.

Has Your Medical and Insurance Information Changed?*

NO. My Medical Information has not Changed. Skip this section.

Yes. I need to UPDATE or PROVIDE medical information

Contact Information

Contact information is for advising and coordination of program information. This information is kept private and is not sold or offered to any 3rd party.

Primary Email Address (Parent or Guardian)*

Enter Email Confirm Email

Additional Email Address (Optional)

Enter Email Confirm Email

Please enter any additional email that you would like to be included in the correspondence.

Mother's Name

First Last

Mother's Cell Phone

Father's Name

First Last

Father's Cell Phone

Other Authorized Guardian*

All authorized guardians are listed above

I wish to authorize another authorized guardian for pickup/drop-off

Guardian's Name

First Last

Cell (Additional Guardian)

Medical Information

Please fill out all fields in this section

Medical or Allergy Conditions*

My child has NO medical or allergic conditions that you need to be aware of.

My child has a medical or allergic condition you need to be aware of.

Please list anything your child is allergic to (drugs, pollen, nuts, etc):*

Does your child have any of the following?

Asthma (incl. exercise-induced asthma)

Diabetes

Epilepsy

Is your child currently taking any medications that we should be aware of?*

Yes

Please list those medications:*

Is there additional information we should know about your child's health or physical condition?*

Yes

Also use this to explain any conditions listed above.

Please explain:*

Insurance Information

Please fill out all fields in this section.

Name of Insurance Company*

Policy Name and Number*

Physician's Name*

First Last

Dr's Phone*

Informed Consent and Terms & Conditions

Authorization for participation and emergency treatment.*

Risk Acknowledgement and Release*

Image Release*

Terms and Conditions

Signature of parent or guardian*

Type in your full name for an electronic signature. By signing above, you agree to the Terms and Conditions, Image Release, and Authorization for Participation as detailed above.

Almost Done! Just one more step

Options and Payment

Please select from the options below for Uniforms, Spirit Wear, and Payment Method.

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Uniform

This field is hidden when viewing the form

UNIFORM*

This program requires that each athlete wear a Fit180 Team uniform on day of race. Image: Fit180 Uniform

I need to Buy a Uniform

Already Have a Fit180 Uniform

This field is hidden when viewing the form

Uniform Size*

Jersey*

Black/White Fit180 Racing Jersey

Jersey - $25

Already Have a Jersey

This field is hidden when viewing the form

Black Shorts*

For this program, athletes may wear their own Black athletic shorts if they choose. Or they may order our shorts here.

Shorts - $20

Already have shorts

Payment Method

Did you receive a unique registration code?

Total

Credit Card*

Cardholder Name

Card Details

Billing Address*

Street Address Address Line 2 City State ZIP Code

"*" indicates required fields

Step 1 of 5 - Athlete Information

Instagram

This field is for validation purposes and should be left unchanged.

Track*

Price:

Athlete's Information

Please fill out all of the required fields in this section.

Athlete's Name*

First Last

Gender*

Male

Female

Date of Birth*

MM slash DD slash YYYY

School*

Grade*

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Competitive Program

Athletes participating in the Competitive Program will need BOTH 1) USATF Membership. 2) Age Verified.

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Do You Already Have a USATF Number?*

A Current USATF Membership number must be obtained prior to participation in USATF events. This number must be linked to Fit180 Athletics. Visit the USATF website to obtain this number.

I have a USATF Number

I Need a USATF Number

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USATF Membership No.*

IMPORTANT: Make sure your USATF # is attached to FIT180 and is not EXPIRED.

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Instructions for Obtaining a USATF No.

To obtain a USATF #, visit the USATF website:
- CLICK HERE to go to the USATF website.
Instructions for obtaining your USATF Membership #:

For insurance purposes each child will need to be a USATF member.
The youth cost for membership per year is $20.
You’ll need to connect your athletes membership to Fit180’s Club number. Fit180 CLUB (#13-0906).

A. www.usatf.org
B. Click on Products/Services
C. Individual membership
D. Complete New Member information and make sure you associate yourself with club #906. The box is on the right side of the screen.
E. Complete payment information. The system will provide payment confirmation and member #.

We need this number in order to get your athlete age verified prior to racing.

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Birth Certificate
Important: For athletes in the Competitive program that are not yet age verified with the USATF, you need to start the process of age verification right away. You will first need to obtain your USATF Membership Number and link it to Fit180 Athletics (Explained above). Then, per USATF rules, we are required to submit a copy of athlete's birth certificate for verification. If they have ever participated in a USATF program, they will not need to be verified again.
Max. file size: 2 GB.

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Age Verification

Before an athlete can participate in a USATF event, they must be age-verified by sending in a copy of the child's birth certificate. Fit180 can do that for you. If your athlete has already participated in a USATF Event, they are already age-verified and do not need to do it again.

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Age Verification*

My Athlete is Already Age Verified

My Athlete Needs to be Age Verified

I'm Not Sure

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Birth Certificate
You can upload a scanned copy here. Or, Mail a copy to Fit180 Athletics 2436 Logan Field Dr. Waxhaw, NC 2813 IT MUST BE LEGIBLE.
Max. file size: 2 GB.

First Time Registration?*

This is the FIRST TIME my athlete has participated in any Fit180 Program

Athlete HAS PARTICIPATED in a former Fit180 program.
If you have already completed a registration for this athlete for a former program, you can choose to SKIP or UPDATE your Contact and Medical Information.
Has Your Medical and Insurance Information Changed?*
This includes relevant conditions, critical allergies, over-the-counter medication, insurance and Doctor information. If nothing has changed since your last registration, please select No.

NO. My Medical Information has not Changed. Skip this section.

Yes. I need to UPDATE or PROVIDE medical information
Contact Information
Contact information is for advising and coordination of program information. This information is kept private and is not sold or offered to any 3rd party.
Primary Email Contact*
Enter Email Confirm Email

Additional Email Address (Optional)
Please enter any additional email that you would like to be included in the correspondence.
Enter Email Confirm Email

Mother's Name
First Last
Mother's Cell Phone
Father's Name
First Last

Father's Cell Phone
Other Authorized Guardian*

All authorized guardians are listed above

I wish to authorize another authorized guardian for pickup/drop-off
Guardian's Name
First Last
Cell (Additional Guardian)

Medical & Insurance Info
Medical Information
Please fill out all fields in this section
Medical or Allergy Conditions*

My child has NO medical or allergic conditions that you need to be aware of.

My child has a medical or allergic condition you need to be aware of.
By signing this form, you are affirming that our child is medically and physically fit to take part in strenuous exercise. However, if there is anything we should know regarding allergies, medicine, or medical conditions, please select the second option and let us know.
Please list anything your child is allergic to (drugs, pollen, nuts, etc):*
Does your child have any of the following?
Asthma (incl. exercise-induced asthma)
Diabetes
Epilepsy
Is your child currently taking any medications that we should be aware of?*

Yes

No
Please list those medications:*
Is there additional information we should know about your child's health or physical condition?*
This includes behavioral conditions, habits, or diagnosis that would prevent your athlete from being able to perform normal practice workouts. Also use this to explain any conditions listed above.

Yes

No
Please explain:*
Insurance Information
Please fill out all fields in this section.
Name of Insurance Company*
Policy Name and Number*
Physician's Name*
First Last
Dr's Phone*

Informed Consent and Terms & Conditions
Authorization for participation and emergency treatment.*
I hereby give permission for my athlete (Named Above), to participate in Fit180 Athletics programs. Further, I authorize the club to provide emergency treatment of any injury or illness my child may experience if qualified medical personnel consider treatment necessary and perform the treatment. This authorization is granted only if I cannot be reached and reasonable effort has been made to do so. My child and I are aware that participating in conditioning, track and field and cross country is a potentially hazardous activity. We assume all risks associated with participation in this sport, including, but not limited to falls, contact with other participants and other reasonable-risk conditions associated with the sport. All such risks to my child are known and understood by my child and me. We understand this informed consent form and agree to its conditions.
Risk Acknowledgement and Release*
I agree that by signing this form, that my minor athlete is a member of Fit180 Athletics (hereinafter “the club”), and I know that running in and volunteering for organized group runs, social events, and races associate with the club are potentially hazardous activities, which could cause injury or death. I will not allow my minor athlete to participate in any club organized events, group training runs or social events, unless he or she is medically able and properly trained, and by my signature, I certify that my minor athlete is medically able to perform all activities associated with the club and is in good health, and properly trained. I agree to abide by all rules established by the club, including the right of any official or coach to deny or suspend my participation for any reason whatsoever. I attest that I have read the rules of the club and agree to abide by them. I assume all risks associated with my minor athlete being a member of the club and participating in all club activities, which may include but no limited to: falls, physical contact with other participants/members, volunteers, race personnel, contract service providers, employees, and spectators including the potential the contraction of a communicable disease resulting from contact with other participants/members, volunteers, race personnel, contract service providers, employees, and spectators. I assume all risks including: the effects of the weather; high heat and/or humidity; freezing cold temperatures; traffic and the conditions of the road including surrounding terrain. I further agree to abide by the Center for Disease Control’s (CDC) recommendations for the prevention of the spread of the 2019 Novel Coronavirus Disease (COVID-19) and other communicable diseases, and I attest to having read the CDC’s guidance at: https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html. I assume all such risks being known, appreciated, and accepted by me. I understand that bicycles, skateboards, baby joggers/strollers, roller skates or inline skates, animals, and personal music players are not allowed in club organized runs or events, and I will abide by all rules of the club. Having read this waiver and knowing these facts and in consideration of your accepting my minor athlete’s membership, I, for myself and anyone entitled to act on my behalf, waive and release Fit180 Athletics and the Road Runners Club of America, all club sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in the club activities, even though that liability may arise out of negligence or carelessness on the part of the persons or organizations named in this waiver. In addition, I acknowledge the contagious nature of COVID-19 and other communicable diseases and voluntarily assume the risk that my minor athlete may be exposed to or infected by COVID-19 and/or other communicable diseases by participating in any activities associate with the club. I acknowledge that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 in connection with my participation in any club activities, and personally assume this risk.
Image Release*
In consideration of my minor child/ward being allowed to participate in any way in the Fit180 Athletics Club program, related events and activities, the undersigned agrees that such participants’ likeness may be photographed or videotaped and that such image may be published in our outlet used to promote or publicize the sports program.
Terms and Conditions
CODE OF CONDUCT Parents • Be a positive role model. • Encourage good sportsmanship among all athletes. • Be supportive of coaches and meet officials. • Respect the coach’s ability to teach and coach your child. Parents may discuss the training program with coaches following practice, if time permits. It is recommended that parents schedule time separate from practice to meet with the coach to discuss concerns. • Arrive to meets at the time given to you by the coach and check in at the designated team area. • Place the physical and emotional well-being of your child above any personal desire that they have to win. • Remember, children are involved in organized sports for their enjoyment, not ours. Be supportive and encourage them to enjoy themselves and to do their best. Athletes • Arrive at practice ready to listen, work hard, learn and give my best effort. • Do your best to be at every scheduled practice. Be on time and prepared. Late athletes will not be allowed to participate in training activities without completing a warm-up. Practices will not be delayed or extended to accommodate late arrivals. • Learn the rules and always compete by them. • Be respectful of coaches, officials, parents, teammates and competitors on other teams. Treat others as you wish to be treated. • Inappropriate behavior and/or language will not be tolerated. Conduct which is not in compliance with the Code of Conduct and/or which is detrimental to the club may result in an athlete's dismissal from the club. FEES WILL NOT BE REFUNDED IN THE EVENT OF DISMISSAL
CANCELLATION POLICY for all Fit180 Programs. Cancellation Fee: There will be a $20 Cancellation Fee for any refund of funds at any time after payment has been received. Maximum Refund will be: (a) If more than 48 hours prior to the start of the program, you will receive a full refund, minus cancellation fee (above), and any other expenses that have been applied, such as uniforms, race fees, etc.., or (b) if after 48 hours prior to start of the program, Maximum refund will be 50% of total program fees. Fit180 Athletics holds the right to further prorate the refund based on the actual participation of the athlete, and expenses incurred. At no time will the refund be greater than 50% of total program fees.
Signature of parent or guardian*
Type in your full name for an electronic signature. By signing above, you agree to the Terms and Conditions, Image Release, and Authorization for Participation as detailed above.

Options and Payment
FREE T-Shirt
This program includes a free T-shirt for your athlete. Brand, Color and Style will vary from year to year.
You Get a Fit180 Free T-Shirt

Free T-Shirt

No Thanks
FREE T-Shirt Size*
Uniform

UNIFORM*
This program requires that each athlete wear a Fit180 Team uniform on day of race.

I Need to Buy a Uniform

Already Have a Fit180 Uniform
Jersey*
Black/White Fit180 Jersey

Jersey - $40

Already Have a Fit180 Jersey
Uniform Size*
This field is hidden when viewing the form
Black Shorts*
Black/White Fit180 Shorts

Shorts - $20

Already Have Fit180 Shorts
This field is hidden when viewing the form
Shorts Size*
Payment Method
Did you receive a unique registration code?

Total

Credit Card*

Cardholder Name

Card Details

Billing Address*
Street Address Address Line 2 City State ZIP Code