North Shore Striders Membership Application Form - 2008 Send completed application and a check made payable to North Shore Striders to (if needed, use multiple forms):    Vicky Yee    51 Winthrop Ave    Beverly, MA 01915 Questions? Contact NSS Membership chair, Vicky Yee, (978) 921-2456. For family membership, list all family members who may participate in club activities: First Name Nickname Last Name When not running Age Birth Date Sex Address  Town/City  State  Zip   Home phone     Work phone Mobile phone   E-mail    Which is your primary phone? Home Work Mobile Do you prefer to get most communications via e-mail and the web site? Yes No Do you wish to have contact/personal info included in the NSS website "Yellow Pages"? Yes No New Renewal                                 Membership Type:   $20/Single $30/Family                                           (Note: Memberships paid after Oct 1 cover also the following year.) Volunteering - Each Strider is expected to volunteer at least 3 times/year. Please check or state your preference(s):    Race Manager    Race Assistant    Club event    Publicity/Web    Other: Goals - to be a Goal-chaser, be specific (see examples on Yellow Pages): Comments: I know that running is a potentially hazardous activity. 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 offical relative to my ability to safely complete the run. Knowing these facts, and in consideration of your accepting my entry fee, hereby for myself, my heirs, executors, administrators or anyone else who might claim on my behalf, convenant not to sue, and waive, release, and discharge the North Shore Striders, including their agents, employees, assigns, or anyone acting on their behalf, from any and all claims of liability for death, personal injury or property damage of any kind or nature whatsoever arising out of, or in the couse of, my participation in this event. This Release and Waiver extends to all claims of every kind or nature whatsoever, foreseen or unforeseen, known or unknown. ____________________________________________   Signature (parent or guardian if under 18 years)                  Date