Membership Registration

Name*
First Last
Date of Birth*
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Emergency Contact Name*
Emergency Contact Phone*
Membership Type*
How Many Total Family Members (Including Yourself)
Family Member 2 Name*
First Last
Family Member 2 Date of Birth*
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Family Member 3 Name*
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Family Member 3 Date of Birth*
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Family Member 4 Name*
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Family Member 4 Date of Birth*
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Family Member 5 Name*
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Family Member 5 Date of Birth*
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Family Member 6 Name*
First Last
Family Member 6 Date of Birth*
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Total
$0.00
Waiver and Release
I agree that I am a member of PR-Performance Running, and I know that running in and volunteering for organized group runs, social events, and races with this club are potentially hazardous activities, which could cause injury or death. I will not participate in any club organized events, group training runs or social events, unless I am medically able and properly trained, and by my signature, I certify that I am properly trained. I agree to abide by all rules established by the club, including the right of an official to deny or suspend my participation for any reason whatsoever, I attest that I have read the rules of the club agree to abide by them. I assume all risk associated with being a member of this club and participating in club activities which may include: falls, contact with other participants, the effects of the weather, including high heat and/or humidity, traffic and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and inconsideration of your accepting my membership, I, for myself and anyone entitled to act on my behalf, waive and release PR-Performance Running, Inc, the city of St. Charles, and the Road Runners of America, all club sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation with the club, even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission to all of the foregoing to use my photographs, motion pictures, recordings or any other record for any legitimate promotional purposes for the club.
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WE PUT THE FUN IN RUN.