Boulder Road Runners Membership Application

Name
Today’s Date
Address

City
State
Zip
Home Phone
Work Phone
Birthdate
If this is a FAMILY membership, please list all members:
Name
Birthdate
Name
Birthdate
Name
Birthdate
Name
Birthdate
Indicate Membership Type
1yr
2yr
3yr
Individual
$25
$45
$65
Family
$35
$65
$95
New Membership Renewal
Please check area(s) of interest:
Newsletter Group Workouts
Races Youth Activities
Track Meets Special Events
Community Events
Other:

Please make checks payable to:
Boulder Road Runners
PO Box 1866
Boulder, CO 80306

Memberships expire 12 months (or 24 months for 2 year or 36 months
for 3 year memberships) from the date of application.
The expiration date will be indicated on your membership card.
The BRR Newsletter is NOT forwarded, so if you have moved or are planning to move, send your old and new addresses and phone numbers to the above address. Thanks!


WAIVER MUST BE SIGNED FOR APPLICATION TO BE PROCESSED

WAIVER: I know that running in and volunteering to work in club races are potentially hazardous activities. I should not enter and run club races unless I am medically able and properly trained. I assume all risks associated with running in and volunteering to work in club races including, but not limited to: falls, contact with other participants, the effects of the weather, including cold, snow and/or ice, 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 single or family membership, I for myself, for members of my family also applying for membership, and for anyone entitled to act on my behalf, waive and release the Boulder Road Runners, all municipalities and all sponsors involved in BRR events, their representatives and successors from all claims and 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.

SignatureDate

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