MEMBERSHIP FORM

CONTACT NAME: ____________________________________________________________

ADDRESS: _________________________________________________________________

CITY, STATE, ZIP: ________________________________________________________

EMAIL #1: ________________________________________________________________

EMAIL #2: ________________________________________________________________

PHONE: _________________________________________ DOB_____________   M   F

FAMILY MEMBERS:

________________________________________________ DOB______________  M   F

________________________________________________ DOB_____________   M   F

________________________________________________ DOB_____________   M   F

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[  ] Individual Membership Dues are $15 per year.

[  ] Family Membership Dues are $20 per year, and include immediate family   

     members, including dependent children through college age.

[  ] I am a new member.  [  ] I am a renewing member.

Please mail to: Anniston Runners Club, P.O. Box 2022, Anniston AL 36202

          ANNISTON RUNNERS CLUB MEMBERSHIP APPLICATION WAIVER

I know that running/working in club races and fun runs are potentially hazardous activities. I should only participate in club activities if I am medically able and properly trained. I agree to abide by any decision of a race official regarding my ability to safely complete the run. I assume all risks associated with working and volunteering in club races, including but not limited to, falls, contact with other participants, the effects of weather (including high heat and/or humidity), the conditions of the road and traffic on the course, any other such risks being known and acknowledged by me. I, having read this waiver, knowing these facts, and in consideration of your acceptance of my application for membership, I for myself and anyone entitled to act on my behalf, waive and release the Road Runners Club of America, the Anniston Runners Club, their representatives and successors, from all claims of liability arising out of my participation in club events even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver.

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SIGNATURE                                                      DATE

If you do not have access to the internet, would you prefer a paper copy    

of the club newsletter mailed to your home? [  ] Yes   [  ] No