P.O. Box 473, Lumberton, NC  28359

 

Membership Application

Name:___________________________________________________________

Address:____________________________________________________________

City: _________________ State: _________________________ Zip Code: _________

Email Address: _______________________________________________

Phone: ______________________________________________________

Waiver:

In exchange for my acceptance as a member of the Robeson Road Runners, I hereby hold harmless and

indemnify the Robeson Road Runners organization and all affiliated persons, including but not limited to

members, sponsors, partners and board members. I agree to abide by Robeson Road Runner policies

and understand that my membership must be renewed annually to receive club privileges without

interruption.

______________________________________________ __________________________

                Signed                                                                                                                  Date

 

______________________________________________ ______________________________

Parent’s signature if under 18 years of age                                         Date

 

Please mail this form and fee payable to the Robeson Road Runners to:

The Robeson Road Runners

P.O. Box 473, Lumberton, NC 28359

Membership Fee: $5 per individual.

 

______ Yes, I would like to be contacted to help organize and plan Robeson Road Runners Events.Type your paragraph here.