Cross Country Signup Sheet

Please answer the following questions and either:

1. email them to Coach Singleton at jsingleton@wpcsd.k12.ny.us

or

2. mail them to

Fred Singleton
White Plains High School
550 North Street
White Plains, NY 10605

FULL NAME ______________________________________________________________

ADDRESS_______________________________________________         ZIP 1060______________

PHONE (PLEASE PRINT VERY CLEARLY) _____________________________________

 EMAIL ADDRESS _________________________________________________

EMERGENCY PHONE NUMBER (MUST BE FILLED OUT) ________________________________

IN EMERGENCY ASK FOR ___________________________________

NAME OF PARENTS/GUARDIANS________________________________________________________

YOUR DATE OF BIRTH__________________________________________________

AGE_______________________                             
GRADE (In September) ________________

COUNSELOR’S NAME________________________________

MY LAST WPHS PHYSICAL WAS_______________________________ (APPROX)

IT WAS FOR WHICH SPORT?____________________________________

HAVE YOU RECEIVED A VARSITY LETTER________________________________

IF SO FROM WHICH SPORT?_____________________________

COMMENTS_____________________________________________ _____________________________________________

APPROXIMATE GPA____________________________________________