Membership Application

Montgomery County Road Runners Club Membership Application
Date

Check one			1 Year	2 Year
New Membership		Individual	$25/yr	$40/2 yrs
Renewal		Family	$40/yr	$70/2 yrs
	If you cannot afford the full membership fee, please contact the club treasurer by email at treasurer@mcrrc.org

NAME	SEX	AGE	Birthdate (mm/dd/yy)	Mailing Address (street address, city, state, zip)

Family Members:				Telephone (home)
				(work)
				Email address:
				Check here if you do not wish to be included on membership lists occasionally provided for running-related services/events.
				Mailing Address Correction?

Liability Waiver

This waiver must be read and signed by each adult member and must be signed by a parent or guardian for each minor member.

I know that running and volunteering to work in club races and other club events are potentially hazardous activities and that I should not enter or participate in such 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 a run. I assume all risks associated with running and volunteering to work at club races and activities including, but not limited to falls, contact with other participants, the effects of the weather, including high heat 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 your acceptance of my application for membership, I for myself and anyone entitled to act on my behalf, waive and release the Montgomery County Road Runners Club, the Road Runners Club of America, 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 this waiver. Further, I hereby grant full permission to any of the foregoing to use any photographs, videotapes, and any other record of club events for any legitimate purposes.

I have read and understand this waiver: (Each adult member must sign)

______________________________ * ______________________________

On behalf of minor members listed above, I have read and understand this waiver:

_______________________________ (sign here)

Please make check payable to MCRRC and mail to:	Amount Enclosed:
MCRRC Membership PO Box 1703 Rockville, MD 20849	Membership:
MCRRC Membership PO Box 1703 Rockville, MD 20849	Contribution*:
*MCRRC is a 501(c)3 not for profit organization, and your contributions may be tax-deductible. Check with your tax advisor	Total: