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Fireweed Runners - JR After School Program 2025/2026
View Info
Contact Us
Clear Form
September 9th - May 12th, 2026
Whitehorse, Yukon
01.
Registrant Information
Registrants
02.
Confirmation
Confirmation
03.
Receipt
Receipt
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Import
Share fields
*
Required
fields
Hide "fixed" error warnings
Please fix the following errors:
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Are you a new or renewing member?
*
Member #
*
Lookup
First Name
*
Last Name
*
Is your Name incorrectly spelled?
Date of Birth
(YYYY
*
-MM-DD)
/
/
No category for this age.
Guardian 1
Guardian 1 Phone Number
-
International Number
Guardian 2
Guardian 2 Phone Number
Emergency Contact
Emergency Contact Phone Number
Other people for pick up
Fireweed Runners organizers may contact you via email with important program information and updates. In addition to the billing email address on file please let us know who else needs to receive these emails.
Opt in to emails
In the event of an accident, I authorize Fireweed Runners employees to provide my child with required first-aid. If required, I authorize transportation by ambulance to alternate healthcare. I authorize Fireweed Runners to release the information provided in this registration form to medical personnel.
Does your child have any medical conditions that we should know about?
Does your child have any behavioral issues we should know about?
Does your child have any allergies or intolerances? If so, what are they?
Is there anything else you would like to tell us about your child?
Distance
Category
*
Select...
Junior grade 4 & 5
There are no available categories for the age of this registrant.
Add another distance
Waivers
I have read and agree
*
AY Waiver
Digital signature
(type your name exactly as entered above "
registrants name
")
*
Parent/guardian digital signature
*
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