Membership
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 CLUB APPLICATION/RENEWAL FORM

Name                                                               Age:       DOB:(M/D/Y)     __Sex::       Occupation:                              

Address                                                                              City:                                               State:                           

Zip:                         
           Home Phone:                            Bus. Phone:                              E-Mail                              
                                  

Other Running Family Member (Same Address)
Name                                                 Age:       DOB (M/D/Y)     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 or e-mail him at drcprez@yahoo.com

*All memberships expire Dec. 31.  Full year dues are $20 per family (one address) and are pro-rated as follows:  During Jan-Mar $20; Apr-Jun $15; Jul-Sep $10; Oct-Dec $25 (Oct-Dec includes next calendar year).Dues are due January 1st for existing members.

            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 Club
                                             PO Box 887,
                                             Dothan, AL 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 required if applicant is under 18 years of age.)

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Date

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