Membership App

River City Runners and Walkers Club Membership Application

Single $14.00_______Family $20.00____Full time students & Seniors 65 & over $8.00____

If you are a new member and join after July 1, pay one-half of the above.
All memberships are renewed January 1st.
Payable to River City Runners Club, P.O. Box 4496, Parkersburg, WV 26104
There will be a $5.00 service charge on all returned checks.

TELL US ABOUT YOU! Miles per week you run?_____ Walk?_______
Years you've been running?_____ Walking?____ Your training pace?_____

Discounts on Running Merchandise....15% at ZIDES....20% on shoes at SHOE CARNIVAL....
15% on shoes at CHAMPS....15% at GNC South
20% on athletic footwear and athletic clothing at RENEE'S BIRKENSTOCK
5% on shoes and 10% on clothing at ON THE RUN....

DATE__________________________________
NAME_____________________________________SEX_____BIRTHDATE_________

ADDRESS_____________________________CITY_____________________________

STATE______ZIP__________HOME PHONE___________WORK PHONE_________

OCCUPATION________________________WHERE___________________________

E-MAIL ADDRESS_______________________________________________________

ADDITIONAL FAMILY MEMBERS JOINING:

NAME________________________BIRTHDATE________OCCUPATION__________

ALL MEMBERS MUST READ AND SIGN THIS WAIVER
I know that running and volunteering to work in club races and related activities are potentially hazardous activities. I should not enter in club activities unless I am medically able and properly trained. I agree to abide by any decision of a club official relative to my ability to safely complete the event. I assume all risks associated with running, any club-related activities, 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 condition 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 your acceptance of my application for membership, I for myself and anyone entitled to act on my behalf, waive and release the RRCA, the River City Runners Club 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 the waiver.

Signature___________________________________________Date__________________

Parent's signature for members under 18 years_______________Date_________________