RESTON RUNNERS MEMBERSHIP APPLICATION
Membership: __ New __ Renewing Member __ Was a member in ____
Type: __ Single __ Two Years [$30] __ One Year [$15] __ Five Years [$75]
__ Family __ Two Years [$50] __ One Year [$25] __ Five Years [$125]
Note: $1.25 of your membership dues is for a subscription to RRCA's quarterly magazine, "Footnotes"
Primary Interest: Running __ Walking __ F__ M __ DOB mm/dd/yy:___/_____/______
NAME (Last, First) ______________________________________________________(print carefully)
E-MAIL ADDRESS: _______________________________________________ (Block print carefully)
CITY_________________________________________________, STATE _____ ZIP ____________
WORK PHONE ______________________ HOME PHONE _______________________
FAMILY MEMBERS (optional);
|Name (first last)||Gender||Birth year||email address (if unique)|
I know that running and volunteering to work in club events are potentially hazardous activities. I should not enter and run in club events unless I am medically able and properly trained. I agree to abide by any decision of an event official relative to my ability to safely complete a run. I assume all risks associated with running and volunteering to work in club events including, but not limited to, falls, contact with other participants, the effects of the weather, including high heat and/or humidity, the conditions of the road and traffic on the course, all such risks being known and appreciated by me. Having read this waiver and knowing these facts, and in consideration of acceptance of my application for membership, I, for myself and anyone entitled to act on my behalf, waive and release the Reston Runners, their respective officers, The Reston Association, and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in these club activities even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of club events for any legitimate purpose. I understand that bicycles, skateboards, baby joggers, roller skates, in-line skates, animals, and audio headsets of any kind are not allowed in Reston Runner events and I will abide by this guideline.
SIGNATURE (18 yrs and older) ___________________________________________ Date _________