Southwest Sprinters Track Club

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2012 Membership Application
Annual Membership Fee:  $25 ( Fee is due on or before February 1, 2011. If submitted after due date, fee is $30)
     
                                                Mailing Address:   Southwest Sprinters TC 
                                                                               Attn: David Jones
                                                                               4706 Pine Circle
                                                                               Bellaire, TX 77401

Club Membership Application Waiver

I know that running and/or volunteering to work in club races are potentially hazardous activities. Furthermore, I understand that I should not participate 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 club activities including, but not limited to, falls, contact with other participants, the effects of the weather, high heat and/or humidity, the conditions of the road and traffic, and any other such risks known and unknown.

Having read this waiver, knowing these facts, submitting this application for the club's consideration and acceptance, I, for myself and anyone entitled to act on my behalf, waive and release the Southwest Sprinters Track Club and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participating in club activities even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver.


First Name
Last Name
Address Line 1
Address Line 2
City
State
Zip Code
Daytime Phone() -
Evening Phone() -
Date of Birth
Event Specialty (example: 100m, long jump, etc.)
4 x 100m Relay Pool ( Y or N )
4 x 400m Relay Pool ( Y or N )
E-mail Address
Comments