Print, Fill out and mail to the below address
Cape Girardeau Road Runners Membership Application
(list all family members)
Name__________________________________________D.O.B.___________
Name__________________________________________D.O.B.___________
Name__________________________________________D.O.B.___________
Name__________________________________________D.O.B.___________
Name__________________________________________D.O.B.___________
Address________________________________________________________
City___________________________________________________________
State________Zip______________Phone_______________________
Email (optional)______________________________________
Dues are (for 12 months): ____$12 Individual/Family payable in January
_______New Member
_______Renewal
Recruited by_____________________________________________
PLEASE SIGN WAIVER BELOW AND SEND TO:
CAPE ROAD RUNNERS Membership 2148 Broadway PMB 172 CAPE GIRARDEAU MO 63701
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 American Association of Running Clubs, the Cape Girardeau Road Runners 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.
Signature and Date___________________________________________________________________
Parents signature if under 18 years old______________________________________________
