NYRR Striders Enrollment Form
Thank you for your interest in joining NYRR Striders! Please complete the following form to process your enrollment. For senior and community centers, please check the residential requirements for eligibility to sign up for programming.
First Name
Last Name
Date of Birth
MM/DD/YYYY Date of Birth is required to participate in NYRR programming and special events
Gender
Please select...
Female
Male
Non-Binary
Other
Are you a returning NYRR Striders Participant?
Yes
No
Primary NYRR Striders site
(i.e location where you hope to participate in striders)
Would you like to update your information?
Yes
No
Email is our primary method of communication. Please add your email to receive important program announcements and updates.
I have a valid email address
I don't have an email address
T-Shirt Size
Please select...
Extra Small
Small
Medium
Large
Extra Large
2X Large
3X Large
T-shirts are an earned uniform incentive with regular attendance.
Email Address
If you have an email address you can add it here, if not leave this field as is.
Phone Number
How did you hear about NYRR Striders?
Home Zip Code
Emergency Contact's First Name
Emergency Contact's Last Name
Emergency Contact's Phone Number
Emergency Contact's Email
Race
Please select...
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Two or More Races
Are you Hispanic or Latinx?
Please select...
Yes
No
I agree to the terms of the NYRR General Liability Waiver found
here
Yes
Contact Information