Dear Parent and/or Guardian,
I am beginning a before school running club for all 3 rd
, 4 th
and 5 th
grade students. The club will meet Wednesday mornings at 8:15am. The first meeting will be Wednesday, September 16 th .
Students who are in the club will learn how to properly warm-up for running, participate in cardiovascular endurance activities, and run laps on our school track to earn fitness feet. The club will conclude with the annual Pumpkin Run on October 16 th at 4pm. Parents will be responsible for transporting their child before school for practice and transporting them to races held at various Elementary schools in the district. If you are interested in being an adult volunteer, please fill out the information on the bottom of this page. Make sure that you are on the approved volunteer list at the District Office. See back of page for running club schedule
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Please complete and return to your child’s Physical Education teacher Mrs. Smedley
I give permission for ______________________________________________________
To participate in the Broad View Running Club before school on Wednesdays at 8:15am.
Student’s Address_____________________________City________________________
Student’s Home Phone #________________________Date of Birth_________________
Parent Name__________________________________Cell Phone/Work #____________
Family Physician______________________________Phone #_____________________
Medical conditions, medication information or allergies we need to be aware of:
________________________________________________________________________
In the event of an emergency, I wish the following person to be notified in case I cannot be contacted:
____________________________________________Phone #_____________________
___YES, I am interested in volunteering at running club practices and/or races. If so, fill out the following information:
Name:__________________________ Email:___________________________________
I understand every effort will be made to contact me to explain the nature of the problem prior to any treatment involved, however, in the event of injury or serious illness, I authorize a qualified physician/surgeon to examine and administer emergency care to the above named student.
RELEASE: In signing this release, I agree to absolve and hold harmless all sponsors, their officers and members, and any other parties connected with this event in any way from and against any blame or liability for any injury, misadventure, harm, loss, inconvenience, or damage suffered as a result of participation in these events.
___________________________ ___________________ ______________________
Signature of Parent/Guardian Date Work/Cell Phone #

Running Club Schedule
Wednesday, September 16 th
: Practice 8:15-8:45am (students will go directly to the walk until
8:55am)
Wednesday, September 23 rd
: Practice 8:15-8:45am
Wednesday, September 30 th
: Practice 8:15-8:45am
Wednesday, October 7 th : Practice 8:15-8:45am
Wednesday, October 14 th
: Practice 8:15-8:45am
Friday, October 16 th
: Pumpkin Run at BVE, 4pm. *One mile run. Students may choose to wear their Halloween costumes to the run (but NOT to school).