West Suburban Harriers
Junior Harriers Program Registration
Athlete Name
*
First Name
Last Name
Athlete Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Female
Male
School
*
Grade Level in FALL 2026
*
Grade 2
Grade 3
Grade 4
Shirt Size for T-Shirt
*
YXS
YS
YM
YL
YXL
AS
Shirt Size for Race Singlet
*
YS
YM
YL
YXL
Men's AS
Women's AS
Parent Name
*
First Name
Last Name
Parent Phone Number
*
Please enter a valid phone number.
Parent E-Mail Address
*
example@example.com
Optional Second E-Mail Address
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I, the parent of the above-named athlete, consent to his/her participation in the West Suburban Harriers, LLC ("WSH") cross country program (“Program”). I know of no restriction or impairment that would limit participation in the Program. Should a medical emergency arise, I authorize WSH coaches to seek medical attention for him/her as they deem appropriate. I will be responsible for all costs of treatment. I release, discharge, and hold harmless WSH and the WSH coaches and volunteers from any and all liability, damage, claim or demand whatsoever on account of participation in the Program, including any injury that may occur. Please check box to confirm your agreement to the above terms:
*
I agree
I, the parent of the above-named athlete, authorize West Suburban Harriers to register him/her for membership with the AAU. Please check box to confirm authorization:
*
I Agree
Please type name in box below to confirm agreement to above terms:
*
Payment
*
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Fall Harriers Program
$
225.00
Payment Methods
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