Online
Membership Form
Club Northwest - Membership Form
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Fill out the form below and send it with payment to:
Club Northwest
P.O. Box 31958
Seattle, WA 98103
You can email Becca Gillespy,
becca@polevaultpower.com with questions.
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Name: _______________________________________
Birth
Date:______________________________
Address: _____________________________________________
City:_____________________ State:_____ Zip:__________
Phone: Day: __________________
Evening:_____________________
email: ______________________
New membership
Renewal
Student Membership ($40) ________
Regular Membership ($50) ________
Family Membership ($75) _________
Lifetime Membership ($750) _______
Freewill donation _________
TOTAL __________
Would you like to run with a group? If so, what pace, locations,
and times are good for you?
Do you have a group of favorite events or distances that you
compete or participate in? What are they?
What do you expect or would you like to see from Club Northwest?
Reasons for joining?
May we post your phone, email and/or answers to #1 and #2 on the
CNW website? (yes / no)
Would you like to be on
the CNW listserver (you can unsubscribe at any time)? (yes / no)
Would you like us to
send you team information? (yes/no)
Your main interest are:
Track
and Field
Cross
Country
Running
Race Walking
Host
social events
Volunteer Info
Rock 'n
Good Times
New Members get a Club Northwest T-shirt; what is your size? S M
L XL XXL