Name______________________________________________________________________________
Address____________________________________________________________________________
City ______________________________________State________Zip__________________________
Telephone (Home)____________________________ (Work) ________________________________
E-mail
_____________________________________________________________________________
Circle
Appropriate: Student
Individual Family
Checks payable to:
Dues are: Student $ 5.00,
Individual $ 15.00 Individual, $20.00 Family
___________________________________________________________________________________
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 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 weather, including extreme 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 Asheville Track 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 this waiver.
WAIVER MUST BE SIGNED:
___________________________________________________________
SIGNATURE (Parent or Guardian must sign
for minor children)
VOLUNTEERS are what makes
our Club go. If you or any family members would be available at upcoming Club
races and events, check here: ________
If you or any family
members have a special skill or interest, let us know: _______________________
______________________________________________________________________________________
Memberships are based on the calendar year
and cover the
period of January 1 - December 31.