Please read this section before proceeding:

►All of the information on this form is kept strictly confidential and is only used by Faithful Soles (FS).

►Please read the PR10K Program Overview if you are not yet familiar with the program.

►Parents: If you know that your school does NOT yet have a "PR10K Code" (first blank below), or you are not certain if your school has enrolled yet in the PR10K program, please enter "TBD" in the "PR10K Code" space provided, then simply fill in the school name, city and state below and proceed with the remainder of the registration, and Faithful Soles will contact the school to either get them enrolled or verify their enrollment if they have already done so.

►Coaches, Teachers and/or School Administrators: If your school has not yet enrolled in the PR10K program, click here to enroll now.

►The entire registration process takes approximately 5-10 minutes to complete, and must be submitted and approved for the student to become a FS member and obtain a FS Runner ID and Password.

►At the bottom of this form, you will click "Submit Form and Proceed to Online Payment" and be taken to "Faithful Soles Membership Plan Selection and Payment Form" where you will choose the term of your FS membership plan (1 year for $15.00 or 2 years for $25.00) and be taken to a secure online payment screen to complete the payment process. When your online payment is completed, you will receive a confirmation screen.

►Items below with an asterisk (*) are required.

*Enter the Faithful Soles "PR10K Code" assigned to your school:

Enter the name of the school, city and state, below only if you do NOT know your school's "PR10K Code" (above) or are uncertain if the school has enrolled yet in the PR10K program (Faithful Soles will then check to see if the school has enrolled and if not, contact the school to complete the enrollment):

Name of School:

School City:       School State:  (please use state abbreviation)

*Student's First and Last Name:  

*Parent or Guardian's First and Last Name:  

*Parent or Guardian's Email Address:  

Enter below the Faithful Soles Runner ID and Password you would like to use to log in:

*Faithful Soles Runner ID:

(Must be a minimum of 5 and maximum of 20 alpha and/or numeric characters with no spaces)

*Faithful Soles Password:

(Must be a minimum of 5 and maximum of 15 alpha and/or numeric characters with no spaces)

 *Mailing Address: This information will be used to email or mail the student's "Faithful Soles Goal Achievement Certificate" (suitable for framing) described in the next section.  Email Certificate (if you are in the United States and prefer to have your certificate mailed to you, please delete this message and type in your address. All members outside the United States will be emailed their certificate.)

 *Main Goal Description:

FS wants to recognize the student's efforts when he/she achieves a main goal they are working towards as described on their "Goal Setting" form (a link to this form will be emailed to you upon completion of registration). Please describe (as specifically as possible) what the student's main goal is (something they are striving to achieve perhaps in the next month to a year). When the student has attained that specific goal, simply email us back (there is a link available to do this from the home page) and we will send them a "Faithful Soles Goal Achievement Certificate" in  recognition of their accomplishment. If you do not have a specific goal in mind at this time, simply enter "TBD" in the space provided and you may submit the goal at a later date.

*Main Goal Date: (please enter in a mm/dd/yyyy format, such as 12/31/2006) If your Main Goal above is related to a specific race, please enter the date of the event. If your main goal is related to something to be accomplished by a certain date, please enter that date. If you do not have a specific date established, please enter the latest date you think you might achieve your goal.

►Male   Female

►Grade (if school is out for the year, please enter the grade they will be in next year):  

►How would you categorize their current physical fitness level:

 Beginner   Intermediate              Advanced

►Which best describes them:

Walker    Racewalker    Walker/Jogger    Jogger    Jogger/Runner    Runner

Wheelchair Athlete                Mobility-Impaired    Other (briefly describe):

►In what type(s) of walking or running events (please note that "None" is an option) have they previously participated and/or are they currently training for? (choose as many as are applicable):

None   1K (0.62 mile)   5K (3.1 miles)

10K (6.2 miles)   Half-Marathon (13.1 miles)

Marathon (26.2 miles)   Ultra-marathon (More than 26.2 miles)

Half-Ironman Triathlon  Ironman Triathlon  Triathlon (all other distances)

 Others not listed above:

►(Optional) In the space below, tell us what else would you like us to know about your child, or you may expand on some of the answers above, such as what you want to see most for them out of the PR10K program: