Name________________________________________________

Address______________________________________________

City_________________State_____________Zip ____________

Email Address_________________________________________

Sex Male____ or Female____

Phone___________________Date of Birth__________________

*Single $15.00 per year______ *Family $20.00 per year______

If family membership: names and birthdates of family members

Please make check payable to: Grand Rapids Running Club

Send check to:

Barb Minier

1685 Pinecroft Ct SW

Wyoming, MI 49519

*Our year for membership runs January through December