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If you would like to fill out and submit the online membership form, click here.  If not, you may print and complete the form below and mail to theaddress listed.                        

MAIL-IN MEMBERSHIP FORM

For the year ending: 12/31/____    Membership status:    ___ New    ___Renewal

Membership Type:    ___ Individual($20)    ___ Family ($30)

Circle events that you would be interested in:  SP-sprints    MD-middle distance 

LD-long distance    XC-crosscountry    DH-decathlon/heptathlon    RE-relays    JU-jumps

HD-hurdles    TR-throws    WP-weight pentathlon    PV-pole vault    RW-race walk

Name:    __________________________________    Birthdate: ____/____/____

Address: _________________________________    Apt. No.: ______

City: _______________________    State: _________________    Zip: _____________

Home phone: (         )___________________    Bus. phone: (          )__________________

Sex: _____    Age:_____        Best days and hours to contact:_______________________________

Family Memberships: Relationship______________________________________

       (Complete a form for each family member who are occupants in your residence.)

Favorite competitions / distances:__________________________________________

Occupation and brief biographical sketch:

Jurmala hotels______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

Please indicate the activities and committees inwhich you will participate.  Participation in
these areas is critical to the success of our club.

Activities:        ___ Track and Field    ___ RoadRacing    ___ Racewalking

                       ___Other (specify)  __________________________

Committees:    ___ Newsletter    ___ Awards    ___ Officiating    ___Membership   

                      ___ Scheduling    ___ Publicity    ___Sponsorship    ___ Equipment

                       ___Other (specify) ___________________________

Each club member is required to work at least onemeet and event per year.

To join our club, print and complete this formand mail with check payable to
"Over The Hill Track Club" to:

Jeff Gerson
5091 Hickory Drive
Lyndhurst, OH 44124

In consideration of my being accepted, I am ingood health, have trained sufficiently intending to compete and be legally bound, dohereby for
Motel barato Hajduszoboszlomyself, my heirs, executors and administrators waive, release and forever discharge anyand all rights and claims for which I may have or which
may hereafter occur to me against "Over The Hill Track Club", their officers,agents, representatives, successors and/or assigns, for any and all
Chania accommodationdamages which may be sustained or suffered by me in connection with my association with,entry in, or arising out of my traveling to,
participating in and returning from any and all meets, events, and associated "OverThe Hill Track Club" functions.

Athletes Signature:_____________________________________    Date: ____/____/____

Parent or Guardian Signature:__________________________________________

(Required if athlete is under age 18)

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