|
|
|
|
New
Individual Member ($45.00) |
|
Renewal- Individual ($30.00) |
USAT Tri
# Name on Card |
|
|
Family membership applies to two or more members of the same immediate family living at the same address. Members will receive products and discounts form sponsors as available. Please make your check payable to Inland Inferno Triathlon Club, and mail to 735 E. Mountain View Glendora, Ca 91741.
|
Your address, telephone number, and date of birth will NOT be published or distributed without your permission. By signing below, however, you authorize the Club to list your name, city, and e-mail address on the Club's website, and in related team materials, including the newsletter. |
| Name: Include all family members joining club |
|
Birth Date: |
| ||
| Address: |
|
E-Mail: |
| ||
|
|
Home Phone: |
| |||
| City, State: |
|
Zip Code: |
|
In consideration of the acceptance of my membership application by Inland Inferno Triathlon Club, I (including and all my heirs, successors, family, and/or representatives) hereby waive, release, and forever discharge any and all rights and claims for damages or injuries which I may receive, incur, or sustain against Inland Inferno, its members, officers, agents, representatives, successors, and/or sponsors in any event or activity I may travel to, enter, or participate in. By signing below, I hereby authorize the Club to include my name in newsletter or newspaper stories including articles posted on the web. I also grant the Club express permission to use photographs of myself in Club newsletter or newspaper articles and for submissions to Club sponsors.
Signature (required):____________________________ Date: ______________
Fee Information, office use only. Your canceled check serves as your receipt. Memberships are annual from the date we receive fees.
Cash: __________ Check Number: __________ Start Date: _________ Renewal Date:__________
