Application

Your information:
Full name:
Email address:
Telephone number: Work Telephone:


Family Members Name and Birthdate:

Mailing Address:
Annual Dues: Check One	Individual $25 Couples $35 Family $40

In consideration of accepting this application, I hereby waive and release any and all rights and claims for damages my child or I may accrue against the Razor City Runners, any representatives, successors, and assigns, for any and all injuries suffered by myself or my child while participating in this running club. I understand that injuries may include, but are not limited to: Broken bones, concussions, injuries to joints, spinal injuries, broken teeth, loss of vision, injury to internal organs, exposure to weather conditions and problems caused by physical stress.

Signature:_____________________________________Date:________________________________________

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