XSNRG Running Club

Membership Application Form

Annual membership dues are $60.00 | Membership year runs from May to the following April.
Preferred payment is by credit card | The payment form immediately follows this application submission.

First Name:

Last Name:

Address:

City:

Postal Code:

Email:

Date of Birth:

Gender:

Male Female

Home Phone:

Cell Phone:

Emergency Contact and Phone:

Your first year with XSNRG:

If this is your first year, where did you hear about us?

A Little About You:

Casual / Fitness Runner
Races 10K to 1/2 Marathons
Races Marathons/Ultras
Races Triathlons/Duathlons
Trail Running

Comments:

T-shirt Size:

Just For the Record:

I would like to receive the club newsletter, presenting news, information and activities related to the club
I acknowledge that I have read, understood and agreed to the Release, Waiver and Indemnity (click here to read)

General Enquiries

Jana Marshall

Socials

David Muirhead

Technical Enquiries

Ed Wong

Welcome to XSNRG Running Club

Contact Us