THIS FORM IS FOR RENEWAL ONLY. To join initially, please mail in the PRINTED FORM as a signed waiver is required.
Individual renewal is $24 and joint renewal is $36 (or $12 and $18 if renewing after July 31st).
Name 1:
birthday:
Name 2:
Address 1:
Address 2:
City:
State: Zip:
Home phone:
Work phone:
Email:
Renewal:
Annual Half-year (after July 31st)
I would like to receive email reminders of runs and other events:
I would like to receive the newsletter in the mail:
I consent to the use of photos from runs and other events that include my likeness on the Club's website or in the newsletter:
I am willing to host an EBFR potluck (typical attendance 20-30):
Current Amount: $