Greater Fort Lauderdale Road Runners - Team Fort Lauderdale Application

Make checks payable to: GFLRRC
Mail to: GFLRRC - Team Ft Lauderdale, PO Box 2512, Ft. Lauderdale, FL 33303-2512
For best results, set page margins to zero before printing.

______________________________________________________________________ E-mail ___________________________________  ______________________   ________      (  ) (  ) First Name                            Last Name            Middle Initial  Male Female ________________________________________________________________________ Mailing Street Address (Indicate Apt. No. and /or C/O) _________________________________   ______________________   _____________ City                                State                     Zip Code               ______   ______   ___________   _____________________________________ Birthdate     Month     Day      Year         Telephone TEAM FORT LAUDERDALE Sign-Up: 5K - 10K - Half - Marathon Training Membership* Date: ________________ Training For: _______________________________ Goals: _______________________________ Running / Walking Experience: _______________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ * $50/1st year; $25/each year thereafter * Payment included for ( )$50/1st year ( )$25/renewal                         T-Shirt ( ) / Singlet ( ): Size Small ( ) Medium ( ) Large ( ) X-Large ( )