Telephone (Home)____________________________ (Work) ________________________________
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.