HILLSTRIDERS RUNNING CLUB MEMBERSHIP APPLICATION

Annual Dues per person

 $25.00

Annual Dues per family (2 or more )

 $40.00
Name __________________________________________ Date ___/___/___
Spouse's Name ___________________________________
Home address______________________________________________________
City ______________ State _____________ Zip _____________
Home Phone
( ____)_____-_______		 Work Phone
( ____)_____-_______		 EMAIL Address
__________________

Mail application with check made payable to "Hillstriders Running Club" to Diana Aven, Hillstriders Treasurer, P.O.Box 1695, Crystal Lake, Il. 60039-1695

updated 3/10/07