DSE Membership/Renewal Form

                                                      

Print this page and send with check made out to DSE. Annual dues for the San Francisco Dolphin South End Runners (DSE) club are $25 individual/ $30 family.  A $5 discount will be applied to individual ($20) and family ($25) households opting for Electronic Newsletter rather than hard copy Snail Mail Newsletter status.
Richard Finley
805 Vega Circle
Foster City, CA 94404


Date_________________________     New Member___  Renewal___

Name_______________________________________________________

Street_________________________________________ Apt._______

City________________________________ State_____ Zip________

Phone__________________________ Work_______________________

E-mail address_____________________________________________

Birthday_____________________________         M____  F____ 


If family membership, please list additional names and birthdays: 

___________________________________________________________

___________________________________________________________

___________________________________________________________


Are you interested in volunteer work? _____________________

Electronic Newsletter (with $5 discount)___  Snail Mail Newsletter___
CLUB MEMBERSHIP APPLICATION WAIVER

I know that running and volunteering to work club races are potentially hazardous activities. 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. I assume all risks associated with running and volunteering to work club races including, but not limited to, falls, contacts with other participants, the effects of the weather, including high heat and/or humidity, the conditions of the road and traffic on the course, all such risks being known and appreciated by me. Having read this waiver and knowing these facts, and in consideration of your acceptance of my application for membership, I, for myself and anyone entitled to act on my behalf, waive and release the Road Runners Club of America, the SF Dolphin South End Road Runners Club and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in these club activities even though that liability may arise out of negligence or carelessness on the part of the person named in this waiver.

___________________________________________________________________________ Signature/Date

___________________________________________________________________________
Parents signature if under 18 years/Date

Additional clauses: I grant permission to all of the foregoing to use my photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose.

I understand that bicycles, skateboards, baby joggers, roller skates, or blades, animals, and radio headsets are not allowed in the race and I will abide by this guideline.