CAJUN ROAD RUNNERS CLUB by bzs14448

VIEWS: 6 PAGES: 2

									                                        CAJUN ROAD RUNNERS CLUB
                                                    P. O. Box 81802
                                            Lafayette, Louisiana 70598-1802

                      MEMBERSHIP RENEWAL/APPLICATION FORM FOR CRRC
CRRC is a non-profit organization whose primary purpose is the promotion and encouragement of
both running and walking for physical fitness and sport. Membership consists of men, women and
children of all ages representing a wide range of fitness levels and running experience.

MEMBERSHIP BENEFITS:
  • Direct mailings of club newsletters, race calendars and race entry forms
  • Membership in Road Runners Clubs of America (national organization) and a subscription to
  Footnotes
  • Regular Club meetings and fun runs
  • Discounts on merchandise at some area sporting goods stores
  • Discounts at some area races

Mail application and membership waiver and check made payable to: Cajun Road Runners Club, (or
CRRC) P. O. Box 81802, Lafayette, LA 70598-1802.

TYPE OF MEMBERSHIP REQUIRED (CHECK ONE):
____Individual- $20 ____Family- $25 ____Senior (60+)- $15                                      ____Youths(17 & Younger)- $15

                                  IMPORTANT INFORMATION NEEDED, PLEASE PRINT


Last Name:______________________________ First Name:________________________ Mid. Init.____


Address:________________________________________City:_______________ State:_____
Zip:________


E-Mail
Address:____________________________________________________________________________


Date of Birth:____/____/____ Age:____               Sex:___ Home Ph.#:________________Business #:_______________


Would you consider being a VOLUNTEER at race events:(Please Circle One)                                            YES             NO


FOR FAMILY MEMBERSHIP ONLY: PLEASE PRINT AND LIST FAMILY MEMBERS IN MEMBERSHIP.
Name:                                                                              Birthdate:                     Age        Sex
__________________________________________________                                           ____/____/____                  ____       ____


__________________________________________________                                           ____/____/____                  ____       ____


__________________________________________________                                           ____/____/____                  ____       ____


__________________________________________________                                           ____/____/____                  ____       ____
I know that running and/or volunteering to work in CRRC events are potentially hazardous activities. I should not enter and/or run in
CRRC activities unless I am medically able and properly prepared and/or trained. I agree to abide by any decision of race/event officials
relative to my ability to safely complete or assist in this organization's activities. I assume all risks associated with running and/or
volunteering to work in CRRC 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 know and appreciated by me. Having
read this CRRC waiver and knowing these facts and in consideration of your acceptance of my application for membership/renewal, I for
myself and none entitled to act on my behalf waiver and release the CRRC, The Road Runners Clubs of America, and all sponsors, their
representatives and successor from all claims or liabilities of any kind arising out of my participation in these CRRC 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
the foregoing to use any photographs, motion pictures , recordings, or any other record of my participation in any CRRC event for any
legitimate purpose.

Signature (Parents if iunder18)__________________________________________________________Date:
_/_________/________

								
To top