Print and mail the following with a check payable to NWFTC at:
P. O. Box 911,
Shalimar, Fl 32579-0911
Membership Type:
___ Student ( $ 10.00 yr - 12th grade and under)
___ Individual ( $20.00 yr )
___ Family ( $ 25.00 yr )
Check One: New Member ___ Renewal___ Address Change ___
Name:________________________________________
Birth date (m/d/y):____________ Sex (m/f) ___
Address:_____________________________________
City/State/Zip:______________________________
Phone (day)___________________ (evening)___________________
E-mail address:_______________________________________
Family Memberships - list additional family members: Name / Date of Birth /
sex :
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
Northwest Florida Track Club Membership Waiver
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 decisions 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 the acceptance of my application for membership, I, for myself and anyone entitled to act on my behalf, waiver and release the Road Runners Club of America, the Northwest Florida Track 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 persons named in this waiver.
___________________________________________Date :signature (if under 18, parent's signature)