Name ____________________________________________________________________
Address _________________________________________________________________
City ____________________________________ State ___________ Zip _____________
Phone (H) __________________________ (W)___________________________
Date of Birth _____________ Sex ____ Email
Address_____________________________
Additional family members (living at same address):
Name ______________________________________ DOB ________ Relation _________ Sex ____
Name ______________________________________ DOB ________ Relation _________ Sex ____
Name ______________________________________ DOB ________ Relation _________ Sex ____
Name ______________________________________ DOB ________ Relation _________ Sex ____
Also,
please let us know if you are interested in any of the following by
circling your choice(s):
|
Helping at races |
Serving on a committee |
|
Race Director |
Writing newsletter articles |
|
Photographer |
Other (please specify): |
|
Web site content |
Send completed application along with Check or Money order payable to
Missouri River Runners for $15 to:
MRR
P.O. Box 1582
Sioux City, IA 51102.