DOTHAN RUNNERS CLUB APPLICATION/RENEWAL FORM
 

Name DOB:(M/D/Y) Sex
Address
CityState Zip Occupation
Home PhoneBusiness Phone E-Mail
  (Note: Email address required to receive newsletter and other club notices.  Email addresses will not be shared with any other
              organization.)

                                           Other Running Family Members (Same Address)
    Name                                                DOB                    Sex               Signature

Meetings are held the first Thursday of each month, unless otherwise stated in various locations.  Place and times will be announced in the Newsletter and on the website.  For more information call Larry Dykes at (334)792-6021 in the evenings.

*All memberships expire Dec. 31.  Full year dues are $20 per family (one address) and are pro-rated as follows:  During Apr-Jun $15; Jul-Sep $10; Oct-Dec $25 (Oct-Dec includes next calendar year).

            The Dothan Runners Club is a non-profit organization depending entirely on volunteers to conduct its activities.  All members are encouraged to work at least one club event a year and may contact a race director or board member to volunteer.

All new members must read & sign the waiver below. Make checks payable to Dothan Runners and mail to Dothan Runners, PO Box 887, Dothan, AL 36302.

MAIL TO: DOTHAN RUNNERS P.O. BOX 887  DOTHAN, ALABAMA  36302

  MEMBERSHIP APPLICATION WAIVER, RELEASE AND INDEMNITY AGREEMENT .
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 Road Runners club of America and the Dothan Runners club and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in these activities even though that liability may arise out of negligence or carelessness on the part of the person named in this waiver. I agree that this waiver will continue to be valid each time I join or rejoin the club.
________________________________________________________________________
Signature (Parent's Signature if under 18 years)
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