Rock River Striders Membership Application

Name:  Birthdate:

Address:  Sex: Male Female

City:  State:  ZIP:

Phone:  Email:

Check one: New Member ____Renewal         Check one: Runner ___Walker ___

Membership Options: 1 year 2 year 3 year Single $10 $18 $26 *Family $15 $28 $40 Sponsor $30 $55 $80 Student $5 *Family Membership: Limited to immediate family members at same address including children 18 and under. Please list names and ages: Make checks payable to "Rock River Striders" and mail to Bonnie Bryan,  409 Dwight St., Kewanee, IL 61443  Please return Form with Check, Thank You!

Are you interested in volunteering for club events? yes no  RRS Races Newsletter Membership Computer Other

Fill out this form, print it, and send it with your check or money order to:   Bonnie Bryan - Rock River Striders - Membership   409 Dwight St.   Kewanee, IL 61443 We apologize for the inconvience of having to mail a check!