Membership Application

TYPE OF MEMBERSHIP:
    Single:  $20
    Family: $25 (one newsletter)
       Check if new member   

 Today's date: / / mm/dd/yyyy

Fill in the information, then print  form, sign waiver and mail to: runLawrence, 2223 Westchester Rd, Lawrence, KS 66049
Make checks payable to: runLawrence


BIRTH DATE
SEX
Name: / / M F
Address:
City: State:  ZIP:
Phone:  
E-mail:
FAMILY MEMBERS (for family membership only)
Name: / / M F
Name: / / M F
Name: / / M F
Name: / / M F
Name: / / M F

Club Membership Application Waiver
I know that running and volunteering to work in club races are potentially hazardous activities. I should not enter and run in club activities unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risks associated with running and volunteering to work in club races 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, such risks being known and appreciated by me. Having read this waiver and 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, run Lawrence and all sponsors, their representatives and successors from all claims or liabilities of any kind of 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.
Signature_________________________________________________ Date__________
              (signature of parent or guardian if participant is under 18)

   Questions about the mailing list or membership? Call Greg Burger at (785) 887-6745