Running Sign-In Log:

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First Name:
Last Name:
Address:
City:
State/Province:
Zip:
Email:
Phone:


Gender:  Male Female
Current Age Group:  
Running Club/Organization you belong to:  
Miles run per week?  
Races run per year:  
Distances of Races:
(Check all that apply)		 5k 10K 1/2 Marathon Marathon
5 Mile 50 Mile 100 Mile
Running shoe brand currently worn:
(Check all that apply)		 Asics Adidas Nike Brooks
New Balance Puma Saucony Reebok
Etonic Mizuno Other:
Number of Shoes Purchased per year:
Length of time/miles shoes worn.
Months worn:
Miles Worn:

Years Running:  
Do you x-train ? yesno
If Yes, which sports:
(Check all that apply)		 Swim Bike Hike Rock Climb
Inline Skate Snowboard Alpine Ski
x-Country Ski Snowshoe Weight Train
Other:
How many months a year do you run?
Do you purchase from catalogues? Yes no
List Your Favorite Races:
Favorite Running/Multi-Sport Magazines?


Thank You

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Telephone (847) 853-8531

111 E. Cook Avenue, Libertyville, IL 60049
Telephone (847) 549-1108