CENTRAL FLORIDA STRIDERS – MEMBERSHIP FORM
Name Age Sex
Date of Birth
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Annual dues: individual $20.00 Family $35.00
Free t-shirt with single membership and 2 free t-shirts with family membership.
Each additional t-shirt is $5.00, except XXL which are $6.00 each.
I would like to order a t-shirt (child medium,
adult small,
X-Large, and XXL) Please
indicate numbers and sizes.
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e-mail address(es) _______________________________________________
Mailing address:
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Phone Number: ________ - _______ -
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Make checks payable to: Central Florida
Striders
e-mail address: dex@centralfloridastriders.org (407)-286-3889
Mail application to: 11955 Lazio Lane, Orlando, FL 32827
(Parent must sign for members less than 18 years of age)
Waiver: I know that running and volunteering to work in club races are
potentially hazardous activities. I should not enter
and run in CFS 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 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 Road
Runners Club of America, the
Central Florida Striders, 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.
| Primary Member Signature: | |
| Other Member Signature(s): |
