Fill out the registration form below and send it to:

Newtown Hawks Cross Country and Track Club

Participants Name ______________________

Address _________________________________________________

Home Phone___________________________

Email Address ____________________________________________

Age ___________   Grade ___________  Birth date _____________

School _______________________________

Parents Names ____________________________________________

Parents cell #'s ____________________________________________

Dr name & phone # ________________________________________

Medical conditions/concerns__________________________________

Registration for : $150.00 per season per participant 5th-8th graders

                             $125.00 per season per participant 2nd-4th graders

Visa or Mastercard (circle)

Name on card________________________________________

Billing address____________________________________________

Card # _______________________________ exp date ____________

_____________________________________________________________

Cross Country  Aug-Nov ____________

Indoor Track Dec-Feb/March _______________

Outdoor Track March-June ____________

Uniform size ______________  cost $30.00

For Summer Camp go to /www.ussportscamps.com/running/ to register.