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Lauren Frazier , Camping Services Branch Administrator                      YMCA of Greater Manchester   30 Mechanic St                                     Manchester , NH   03101 (603)-232-8642

2018 FOSS RUNNING CAMP Registration
($200 non-refundable fee must accompany this form)
Make check payable to: YMCA-Foss Running Camp
Balances are due by March 1, 2018 for week 1 and April 15, 2018 for week 2.     

Week 1: August 12-18 | Week 2: Aug 19-25

Name: ____________________________________   Sex:  M   F    DOB: ____-____-____

Your School: _______________________________   Coach's Name: _______________________________

Parent/Guardian: ____________________________   Home Phone: (____) ____-____   Cell Phone: (____) ____-____    Email Address: _________________________

Address: ___________________________________   City: ___________________  State: ____  Zip: ________

Emergency contact person: ___________________________   Phone #: (____) ____-____

In consideration of this application being accepted by FOSS RUNNING CAMP, I hereby for myself, my heirs, executors, administrators and assigns, waive and release forever any and all rights or claims whatsoever that I may have against FOSS RUNNING CAMP, its Director, Administrators, or any staff appointed by them for any injury/illness that may be suffered by me arising out of or in any way connected with my attendance at FOSS RUNNING CAMP.

FOSS RUNNING CAMP has my permission to administer care in the event of injury or illness.

I certify that I am physically fit, have had a physical examination and have trained for my participation at FOSS RUNNING CAMP.

Date: ____-____-____

Runner's Signature: _________________________ 

Parent/Guardian Signature (if under 18): __________________________

EMAIL ADDRESS [PRINT-Case Sensitive] ___________________________________________________________

If you do not hear back from us in 4 weeks call Lauren Frazier or e-mail at