FootZone Runners Club Application

Applicant Information
First Name:
Last Name:
Date of Birth:
Email:
Phone (day):
Phone (night):
Address Information
Address:
City/State:
Zip:
Training Information
Please indicate the training program(s) you are interested in. These programs will be communicated to each member in monthly installments via email and will be executed during the weekly runs as directed. 5k 10k Half-Marathon Marathon
Membership Dues
The first day of the month in which you pay your dues is your Anniversary Date for membership. It will be indicated on your mailing address label, and you will recieve a renewal application 15 days before this date.
New or Renewal with uniform	$50
New or Renewal without uniform	$30
General Information
Approximate Pace (min/mile):
Are you interested in leading a pace group?:	Yes No
Are you interested in leading a weekly run?:	Yes No
Are you interested in volunteering at races?:	Yes No
Additional Interests:

Once we recieve the application we will call for verification and ask for payment over the phone. By submitting this application, I verify that the information provided is complete and accurate to the best of my knowledge. I also accept the terms and conditions of the waiver.