SWS Membership Application

Southwest Sprinters Track Club

Membership Application Form

4706 Pine Circle ● Bellaire, TX 77401 ● (713) 201-1934

Application for*

New MembershipRenewal Membership

First Name

Last Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.

Email

example@example.com

Date of Birth

Date

Gender (Check One)

MaleFemale

Category (Check One)

YouthOpenMasters

Events - Indoor

	Check All that Apply	Performance (Last 5 Years
60M
200M
300M
400M
800M
1500M
1600M
3000M walk/run
60M Hurdles
Pentathlon
Weight Throw
Shot Put
Long Jump
High Jump
Triple Jump
4x200 Relay
4x400 Relay
4x800 Relay

Events - Outdoor

	Check All that Apply	Performance (Last 5 Years
100M
200M
400M
800M
1500M
1600M
100M Hurdles
110M Hurdles
400M Hurdles
3000M Steeplechase
5000m Racewalk
Weight Throw
Shot Put
Long Jump
High Jump
Triple Jump
Weight Throw
Shot Put
Discus Throw
Hammer Throw
Javelin
Decathlon
Heptathlon
4x100 Relay
4x400 Relay
4x800 Relay

Please add achievements, Awards, Titles, Records or Comments for the SWS Website Roster

Optional

Please add a profile photo(s) for the SWS Website Roster

Annual membership dues are $60.00.
An additional $10 Late Fee will be assessed after March 1st.
Members must be current on dues to be considered for relays.

Please Mail Check to:
Southwest Sprinters Track Club
13139 Berry Blvd.
Warrensville Hts, OH 44128

or

Online Payment
$60.00 + $2.00 transaction fee

Online payment using PayPal

Club Membership Application Waiver
I know that running and/or volunteering to work in club races are potentially hazardous activities. Furthermore, I understand that I should not participate in club activities unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risks associated with club activities including, but not limited to, falls, contact with other participants, the effects of the weather,high heat and/or humidity, the conditions of the road and traffic, and any other such risks known and unknown.

Having read this waiver, knowing these facts, submitting this application for the club's consideration and acceptance, I, for myself and anyone entitled to act on my behalf, waive and release the Southwest Sprinters Track Club and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participating in club activities even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver