Title 1 School Zoomerangs Registration

Zoomerangs- Fleet Feet Youth Running Program 
Fall 2015 Program Information 

If you have more than one child, you must fill out separate online forms for EACH child.

Registration Details:
Our popular Zoomerangs Children's Running Program is aimed at kids from 5 to 12 years in age. (If you have a teenager and want them to become more active, please consider our No Boundaries "Couch to 5k" Training Class; a parent must also join No Boundaries- Ask us for more details!) Zoomerangs will meet every MONDAY at 5:45pm, starting on Monday, September 14th, 2015 at Jones Elementary. This is a 6 week program and will run from Monday, September 14th, 2015 to the Goal Race. The training will end with your child's participation in the annual Fleet Feet Lederhosen Lauf 5k or 1 mile Fun Run. (your child's training program fee DOES NOT include the race entry fee). If you have any questions about cancellations or the workout, please call the Fleet Feet KingsPointe Store: (918)492-3338 - press 1 for our Fleet Feet KingsPointe Store. We will try to email everyone in a timely manner if we have to cancel a workout.

You MUST have completed your child's registration AND medical release form PRIOR to your child's participation in this program. If you have not completed AND turned in your child's registration AND medical release PRIOR to dropping them off at Jones Elementary, they WILL NOT be able to participate. You may drop them off at the park and you MUST be back by 6:45pm to pick up your child or you will be charged $1.00/minute.

Our program is a "drop and go" program, but parents are welcome to stay and watch as a spectator. Although we appreciate the offer to help, we are not able to accept coaching help from parents, as all coaches and staff working with our Zoomerangs participants are required to submit to a background check prior to the start of the program. At the start of each workout, all of our Zoomerangs runners will meet their coaches for a group "Coaches Minute & Warm-Up" before their workout. Following their workout, we will dismiss the runners to their parents or guardians at the school. Parents or legal guardians must be the one who picks up the Zoomerangs participants, unless other arrangements are made by contacting our Training Program CoordinatorIN WRITING, prior to the start of the workout.

Dates to Remember

First Run: Monday, September 14th at 5:45pm at Jones Elementary School
Coaches Meet & Greet and first workout. Please bring your child dressed to run. Don't forget to bring your completed medical and consent forms! -- Your child CANNOT participate until we have these signed AND completed forms!

T-Shirt Pickup
Our special ZOOMERANGS cotton t-shirt will be available for pickup within the first couple of weeks of the program. More details are forthcoming via your weekly Zoomerangs email.

Lederhosen Lauf 
The goal event for our Zoomerangs runners will be the annual Fleet Feet Lederhosen Lauf 5k or 1 mile Brat Trot. Your Zoomerangs registration fee DOES NOT include your race fee. More details can be found via our website: www.fleetfeettulsa.com. You can register for this event online! This is your child's "goal event" and it is sure to be LOADS of FUN!

I am the parent or legal guardian of __________________, a minor (Participant). I agree that the Participant may participate in the Zoomerangs Childrens Running Program. The purpose of the program is to encourage children to participate in regular physical activity through running. I understand that during the program, the Participant will be involved in physical activities and that running is a potentially hazardous activity. Physical reactions to exercise may include heat-related illness, abnormal heartbeats and blood pressure and, in rare instances, events such as heart attacks. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releasees or others, and assume full responsibility for the Participants participation. Recognizing the risks of the program, and in consideration for allowing the Participant to participate in the program, I hereby release, discharge and agree to hold harmless, and to indemnify Fleet Feet Sports Tulsa, Inc., its owners, directors, officers, contributors, sponsors, employees, contractors, agents and assigns against and from any cause of action, claims, demands, damages, costs, loss of services, expenses, compensation, all consequential damages and attorneys fees (regardless whether pursuant to the laws of any country or state) claimed by, through or on behalf of me or the Participant related directly or indirectly to the program, and specifically including any and all claims for personal injuries sustained while participating in program activities without regard to negligence or negligent conditions. I understand this Fleet Feet Sports location is an independent licensee of Fleet Feet, Incorporated and independently operates this Zoomerangs Childrens Running Program. I further authorize and empower the program director or a coordinator, if after a reasonable attempt has been made to reach a parent, guardian, or emergency contact, to obtain consent, or if sound medical practice decrees that there is not time to make such an attempt, to consent to and authorize any medical care or treatment for the Participant that may appear reasonably necessary as a result of emergency, accident, or illness of the Participant whether occurring before, during, or after the event. I assume full responsibility for the cost of any treatment given. Further, I hereby release, consent to, and authorize, in advance, any such use of the Participants name, photograph, voice or likeness by the foregoing parties in any manner they deem appropriate and necessary without remuneration to the Participant. I also certify that the above Participant has been examined within the last year by a physician and has been determined fit to participate in rigorous athletic activities. I hereby warrant and represent I have carefully read this consent and agree to its terms and conditions, that before signing this agreement I had the chance to ask questions; and I am aware that by signing this consent, I assume all risks and waive and release certain substantial rights that I and the Participant may have or possess against the releasees. To the extent permitted by applicable law, I hereby irrevocably and unconditionally waive trial by jury in any legal action or proceeding related to this agreement. I have fully read the above permissions and releases, understand them, and I expressly agree to them. I am the parent or legal guardian of the Participant, and this permission and release is binding on me and my executor, administrators and heirs.
Please List any and all medical conditions and allergies - If none, put NONE in the box below
Insurance Carrier/Plan Name
Name of Insured*
Relationship to Participant
Group #
Policy #
Physician’s Name & Phone #
Dentist’s Name & Phone #
Phone Number
Zoomerangs Youth Running Program The following is designed for those situations where minors are unaccompanied by either parents or legal guardians. This “Medical Treatment Authorization and Consent Form” gives authority to a designated adult to arrange for medical care for a minor in the event of an emergency. This is extremely important, in that, medical care cannot be provided to a minor without approval by the parents or legal guardians, unless there is written consent authorizing an agent to give approval. The undersigned do hereby authorize Fleet Feet Sports Tulsa, Inc. or such substitute as he/she may designate as agent for the Undersigned to consent to any X-Ray, anesthetic, medical, dental, or surgical diagnosis or treatment and hospital care for the above named minor which is deemed advisable by and to be rendered under the general or special supervision of any physician and/or surgeon, licensed under the Provision of Medicine Practice Act whether such diagnosis or treatment is rendered at the office of said physician, at a hospital, or elsewhere.
(Shirts are short-sleeved, UNISEX COTTON tees)

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