ORTC Membership

Oak Ridge Track Club

Membership Application

Name:        ____________________________________Date of birth: _________ Sex [M/F]: ____

Name:        ____________________________________Date of birth: _________ Sex [M/F]: ____

Address: (Please also include Email) 

   __________________________________________________________

   __________________________________________________________

Telephone: Work\Cell: ____________________ Other: ______________________

Type of Membership*:

                        Individual:                    ____                (Annual dues - $15.00)

                        Family [2 or more]:       ____                (Annual dues - $20.00)

List other household members by name: 

________________________________________ Date of birth ________Sex ______

________________________________________ Date of birth ________Sex ______

________________________________________ Date of birth ________Sex ______

I agree to a membership with Oak Ridge Track Club (ORTC).  I hereby hold Oak Ridge High School (ORHS), ORTC & its related officials harmless for any illness or injuries sustained (both directly or indirectly afterwards) from participating in ORTC sponsored races or coaching sessions on the campus of ORHS or any other physical locations that sporting events are held. 

I further release my right to pursue legal action against ORTC or ORHS for any damages to personal property (both directly or indirectly afterwards) while participating in ORTC sponsored athletic events.

Signed: _________________________________________

Signed: _________________________________________

Date:    _________________

Please make checks payable to Oak Ridge Track Club

To Mail Application & Fees, Sent Inquiry to: ORTC7@aol.com

*33% of net proceeds are donated to college scholarships for distance runners. Membership cards will be mailed and provide race discounts. Fees cover a 12 month period (renewable on anniversary date).