What are the benefits of being a dues-paying member of the SVR? Tell your browser to print the following application if you are interested in joining!
Membership Period - Through December 31,2007

Annual Fee (circle one): ---$10 Individual---$15 Family---$5 Full-Time Student---$100 Individual Lifetime

Type of Membership (circle one): ---Renewal---New Member


Name: ____________________________________________________ Date of Birth: _______ Sex: ____

Name: ____________________________________________________ Date of Birth: _______ Sex: ____

Name: ____________________________________________________ Date of Birth: _______ Sex: ____

Name: ____________________________________________________ Date of Birth: _______ Sex: ____

Address: Street or P. O. Box ________________________________________________

City: _______________________________________ State: ________ ZIP: ___________________

Phone: ( _____ ) _________________________________________________________

E-mail address: __________________________________________


Membership Release - Required

In consideration of your acceptance of my membership in the Shenandoah Valley Runners, Inc., I do hereby release the Shenandoah Valley Runners, Inc. and its Board of Directors and the American Association of Running Clubs and its Board of Directors from any and all liability for illness, injury, or damages of any kind which I may suffer as a result of my participation in the club and its activities. I understand that the club may use my name as appropriate for publicity and promotion without liability or obligation to me. Furthermore, I do hereby certify that I am 18 years of age and/or am signing this waiver on behalf of myself and all minors listed above for whom I have guardianship.

Signature: ______________________________________________________________ Date: ________

Signature: ______________________________________________________________ Date: ________


Make checks payable to Shenandoah Valley Runners & send this form to the address below.

Shenandoah Valley Runners, Inc.
c/o J. David Black, Treasurer
402 South Stewart St.
Winchester, VA 22601-4019



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