Have questions about our club? Check out our on-line Membership FAQ
Our annual membership fees are $20 for individual memberships, and $30 for families. Memberships run from January 1 through December 31* and are renewable on a yearly basis. To become a member of the Somerville Road Runners, please print this form, fill it out, and send it along with the appropriate membership fee to:
Somerville Road Runners
P.O. Box 442048
West Somerville MA 02144-0018
* (New memberships will be pro-rated: the fee for membership in January, February, March is $20.00/Individual, $30:00/Family;
April, May, June is $15.00/Individual, $22.50/Family;
July, August, September is $10.00/Individual, $15.00/Family; memberships started in October, November, December will be good through December of the next year, the
fees are $25.00/Individual, $37.50/Family)
Checks should be made out to "Somerville Road Runners, Inc."
Please contact Membership Director Yili Yao if you have any questions.
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____ New Membership ____ Individual ____ Family ____ Wheelchair |
____ Renewal ____ Check here if your information has NOT changed ____ Individual ____ Family ____ Wheelchair |
Address ________________________________________________
City ___________________________ State _____ ZIP _________
E-mail _________________________________________________
(Please send newsletter by email (PDF):______ snail mail:______)
Cell Phone ( _____ ) _______________
Work Phone ( _____ ) _____________
Additional Family Members:
________________________________ _____ ______________
________________________________ _____ ______________
________________________________ _____ ______________
________________________________ _____ ______________
I know that running is a potentially hazardous activity.
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. Knowing
these facts, and in consideration of your accepting my membership fee,
I hereby for myself, my heirs, executors, administrators or anyone else
who might claim on my behalf, covenant not to sue, and waive, release,
and discharge the Somerville Road Runners, Inc. including their agents,
employees, assigns, or anyone acting on their behalf, from any and
all claims of liability for death, personal injury or property damage
of any kind or nature whatsoever arising out of, or in the course of,
my participation in this club. This Release and Waiver extends
to all claims of every kind or nature whatsoever, foreseen or
unforeseen, known or unknown.
Signature ________________________________________ Date _______
Signature of parent or guardian (if under 18 yrs.) ________________________________________________ Date _______
Signature _______________________________________________
Date : __________________________________________________
Name M/F Date of Birth