#841"A running club for
runners of all abilities."
#158
MEMBERSHIP APPLICATION
Name____________________________________________Sex_____BirthDate__________
Address_____________________________________________________________________
City/Town_____________________________________________State_____Zip___________
Phone Number_____________________________
e-mail:______________________________
Do you want to be included on The Res-Dogs e-mail list? Yes_____No____
(The Res-Dog e-mail list is a EORC communication tool.)
Membership Fees: ____Adult $15.00 ____17&under $10.00 ____Family $25.00
Name__________________________________Relationship________
Name__________________________________Relationship________
Name__________________________________Relationship________
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 decisions of a
race official relative to my ability to safely complete the run. I assume all risks
associated with running and volunteering in club races including, but not limited to:
falls, contact with other participants, the effects of weather, including high heat and/or
humidity, the conditions of 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 the membership, I, for myself and anyone entitled to
act on my behalf, waive and release Road Runners Club Of America, The Empire One Running
Club Inc. and all sponsors, their representatives and successors from all claims or
liabilities of and arising out of my participation in these club activities even though
that liability may be of negligence or carelessness on the part of the persons named in
this waiver.
*"ALL MEMBERS ARE REQUIRED TO WORK
AT LEAST ONE EORC EVENT PER CALENDAR YEAR."
SIGNATURE:_________________________________DATE_________
[Parents if under18]_____________________________DATE_________
MAIL FORM AND FEE TO:Follow this link to join the EORC Resdogs e-mail list (EORC Members only)