Orlando Front Runners

Orlando Front Runners & Walkers Member Information Form

Name: _________________________________________________________________________

Street Address: __________________________________________________________________

City: _____________________________ State: ________ Zip Code: _____________

Home Phone: ___________________________________ OK to place on phone list? Yes No

Work Phone: ___________________________________ OK to place on phone list? Yes No

Email Address: __________________________________ OK to place on phone list? Yes No

May we e-mail you our monthly newsletter? (to conserve postage money) Yes No

Date of Birth:________________________

OFR Publication Permission:
Members’ names are sometimes published in our newsletter and we also put out a list of members’ telephone numbers. Please check one of the following:
    __   It OK to publish my full first and last name in the OFRW newsletter and phone list.
    __   Please only publish my first name and last initial in the OFRW newsletter and phone list.
    __   Please do not include me in the OFRW newsletter and phone list.

OFR Photo Policy:
From time to time, we photograph Frontrunner member events. If you are camera-shy, please convey this to the photographer. It is your responsibility to inform those taking pictures that you do not wish to be photographed. We are happy to comply with your wishes.

Annual Membership Dues: (All memberships expire on May 1^st)
Standard Membership Rate: $20.00 ($15.00 after November 1^st
Couple Membership Rate (same household): $35.00 ($25.00 after November 1^st)
Note: A limited number of sponsored memberships are available in cases of financial hardship. Write "Sponsored Membership" on the top of this form if you are requesting a sponsored membership in OFRW. All requests for sponsored memberships will remain confidential.
$1.25 of the dues amount is for a subscription to the Road Runner Club of America's quarterly magazine, Footnotes.

If you are a first-time member, how did you find out about Orlando Front Runners & Walkers?
    __   Newspaper
    __   Other Member (please give name): ____________________________________
    __   OFR Social Event
    __   Other: ____________________________________

Liability Release:
In consideration of my participation in the Orlando Front Runners, I, the undersigned, intending to be legally bound hereby, waive and release for myself, my heir, executor, administrators and assigns, any and all rights and claims for damages, demands and any other actions whatsoever, which I may have against the Orlando Front Runners, its representatives and its supporters, successors and assignees, arising out of my participation in any event sponsored or attended by the Orlando Front Runners, including any and all injuries suffered by me as a result of my participation in said events.
I verify that I have full knowledge of the physical requirements and the risks involved in participation, and that I am physically fit and have sufficiently trained for said events. Unless specifically stated at the time of said events, I acknowledge that there will be no medical support available.

Signature: _______________________________________________ Date: ______________

OFRW USE ONLY: Amt Paid: ______ Date: _______ Rec'd by: _________ Membership #: _______