Colonial Road Runners Membership Application

Name ______Age ______Date of Birth ______Address ______City/State/Zip ______E-mail ______Phone - Home ______Cell ______Work ______

 New Membership  Renewal  Additional donation to CRR Scholarship Fund ______New and renewal memberships also available online at www.RunSignUp.com (surcharge applies) Membership Fees: One-Year Two-Year Three-Year  Student  $10  $20  $30  Individual  $15  $30  $45  Family (list below)  $20  $40  $60 / / First Name Last Name Gender Age Date of Birth E-mail Address / / First Name Last Name Gender Age Date of Birth E-mail Address / / First Name Last Name Gender Age Date of Birth E-mail Address / / First Name Last Name Gender Age Date of Birth E-mail Address

Volunteer:  Yes  No Check volunteer areas where you can help:  CRR race finish line crew  Group run organizer  CRR clothing sales  Race course marshal/water stop  Distribute CRR race flyers  Race director/committee chair  Host CRR socials or fun runs  Youth running program  Race computer (data entry) upcoming CRR race information, major race Would you like to be placed on the CRR email list (for entry deadlines or entry limit closeouts, etc.)? club functions, socials, club news, team opportunities,  Yes  No For future CRR newsletters, how would you like to receive your newsletter? (OK to check more than one box):  By postal mail  By email attachment (.pdf)  By email reminder (reminder email sent, then can view directly on the CRR website at www.colonialroadrunners.org) Make check payable to Colonial Road Runners, Inc., and mail to: Rick Platt, Membership, Colonial Road Runners, 113 Anthony Wayne Rd., Williamsburg, VA 23185. Membership cards will be emailed. For questions or further info, contact Rick Platt (757-229-7375, 757-345-1431, [email protected]) 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, 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 Colonial Road Runners, Road Runners Club of America (RRCA), USATF, 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 my arise out of negligence or carelessness on the part of the persons named in this waiver.

Signature ______Date ______Parent’s Signature (if under 18 years of age) ______Date ______